Can generic scores (Pediatric Risk of Mortality and Pediatric Index of Mortality) replace specific scores in predicting the outcome of presumed meningococcal septic shock in children?

Leteurtre, Stéphane; Leclerc, F.; Martinot, A.; Cremer, R.; Fourier, C.; Ardıç, Sadık; Grandbastien, Bruno

doi:10.1097/00003246-200106000-00033

Cited by 44 publications

(38 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Os autores apontam como uma vantagem do PIM em relação ao PRISM o fato de o PIM ser baseado em apenas oito variáveis, todas coletadas no momento da internação, o que facilitaria a coleta dos dados e evitaria o efeito no resultado do escore após 24 horas de diferentes estratégias de manejo intensivo 14 . Diversos artigos que avaliaram o PIM mostraram que ele apresenta um bom desempenho para predizer morte [11][12][13][14][15][16] . Em 2003, o PIM Study Group publica uma versão revisada do PIM, o PIM-2 16,17 , que, comparada à versão original 18 , seria mais bem calibrada, mais segura e com melhor ajuste em diferentes grupos diagnósticos.…”

Section: Introductionunclassified

“…Diversos artigos que avaliaram o PIM mostraram que ele apresenta um bom desempenho para predizer morte [11][12][13][14][15][16] . Em 2003, o PIM Study Group publica uma versão revisada do PIM, o PIM-2 16,17 , que, comparada à versão original 18 , seria mais bem calibrada, mais segura e com melhor ajuste em diferentes grupos diagnósticos. Essa nova versão ainda não foi avaliada de forma independente, carecendo de maiores informações quanto a sua performance em outras regiões e, por ter sido publicada após o início deste estudo, não está incluída neste trabalho.…”

Section: Introductionunclassified

“…Até o momento, estudos independentes não utilizaram grupos de pacientes heterogênicos próprios da UTIP, mas algumas categorias específicas de doença 11,16,21 , novas versões do método 10 ou grupos de pacientes homogêneos de alta mortalidade 22 . Nenhum estudo nesse sentido foi publicado na América Latina.…”

Section: Introductionunclassified

See 2 more Smart Citations

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Martha¹,

García²,

Piva³

et al. 2005

J Pediatr (Rio J)

View full text Add to dashboard Cite

Resultados: Internaram na unidade de terapia intensiva pediátri-ca 498 pacientes, sendo 77 excluídos. Dos 421 pacientes estudados, 33 (7,83%) foram a óbito. A mortalidade estimada pelo PRISM foi de 30,84 (7,22%), com standardized mortality rate 1,07 (0,74-1,50), z = -0,45. Pelo PIM, foi de 26,13 (6,21%), com standardized mortality rate 1,26 (0,87-1,77), z = -1,14. O teste de ajuste de Hosmer-Lemeshow obteve um qui-quadrado 9,23 (p = 0,100) para o PRISM e 27,986 (p < 0,001) para o PIM. A área abaixo da curva ROC foi 0,870 (0,810-0,930) para o PRISM e 0,845 (0,769-0,920) para o PIM. Teste de Spearman r = 0,65 (p < 0,001).Conclusão: Na análise dos testes podemos constatar que, embora o PIM apresente uma pior calibração no conjunto dos resultados, tanto o PRISM como o PIM apresentaram boa capacidade de discriminar entre sobreviventes e não sobreviventes, constituindo-se em ferramentas de desempenho comparáveis na avaliação prognóstica de pacientes pediá-tricos admitidos em nossa unidade. AbstractObjective: To compare the performance of the PRISM (Pediatric Risk of Mortality) and the PIM (Pediatric Index of Mortality) scores at a general pediatric intensive care unit, investigating the relation between observed mortality and survival and predicted mortality and survival.Methods: A contemporary cohort study undertaken between 1 June 1999 and 31 May 2000 at the Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas pediatric intensive care unit. The inclusion criteria and the PRISM and PIM calculations were performed as set out in the original articles and using the formulae as published. Statistical analysis for model evaluation employed the Flora z test, Hosmer-Lemeshow goodness-of-fit test, ROC curve (receiver operating characteristic) and Spearmans correlation tests. The study was approved by the institutions Ethics CommitteeResults: Four hundred and ninety-eight patients were admitted to the pediatric intensive care unit, 77 of whom presented exclusion criteria. Thirty-three (7.83%) of the 421 patients studied died and 388 patients were discharged. Estimated mortality by PRISM was 30.84 (7.22%) with a standardized mortality rate of 1.07 (0.74-1.50), z = -0.45 and by PIM this was 26.13 (6.21%) with a standardized mortality rate of 1.26 (0.87-1.77), z = -1.14. The Hosmer-Lemeshow test gave a chi-square of 9.23 (p = 0.100) for PRISM and 27.986 (p < 0.001) for PIM. The area under the ROC curve was 0.870 (0.810-0.930) for PRISM and 0.845 (0.769-0.920) for PIM. The Spearman test returned r = 0.65 (p < 0.001).Conclusion: Analyzing the tests we can observe that, although the PIM test was less well calibrated overall, both PRISM and PIM offer a good capacity for discriminating between survivors and moribund patients. They are tools with comparable performance at the prognostic evaluation of the pediatric patients admitted to our unit.

show abstract

Section: Introductionunclassified

See 1 more Smart Citation

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Martha¹,

García²,

Piva³

et al. 2005

J Pediatr (Rio J)

View full text Add to dashboard Cite

show abstract

“…14 Several articles that have evaluated the PIM have shown that is performs well at predicting death. [11][12][13][14][15][16] In 2003 the PIM Study Group published a revised version of the PIM, the PIM-2 16,17 which, compared with the original version, 18 is supposed to be better calibrated, safer and better adjusted for varying diagnostic groups. This new version has not yet been evaluated independently and more information is necessary with respect of its performance in other regions and, because it was published after this study began, it was not investigated.…”

Section: Introductionmentioning

confidence: 99%

“…To date, those studies that have been performed independently have not used heterogenic groups of patients from PICUs, but have investigated certain specific disease categories, 11,16,21 new versions of the methods 10 or homogenous groups of high mortality patients. 22 No studies of this type have been published in Latin America.…”

Section: Introductionmentioning

confidence: 99%

Comparação entre dois escores de prognóstico (PRISM e PIM) em unidade de terapia intensiva pediátrica

Martha¹,

García²,

Piva³

et al. 2005

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To compare the performance of the PRISM (Pediatric Risk of Mortality) and the PIM (Pediatric Index of Mortality) scores at a general pediatric intensive care unit, investigating the relation between observed mortality and survival and predicted mortality and survival.Methods: A contemporary cohort study undertaken between 1 June 1999 and 31 May 2000 at the Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas pediatric intensive care unit. The inclusion criteria and the PRISM and PIM calculations were performed as set out in the original articles and using the formulae as published. Statistical analysis for model evaluation employed the Flora z test, Hosmer-Lemeshow goodness-of-fit test, ROC curve (receiver operating characteristic) and Spearman s correlation tests. The study was approved by the institution s Ethics CommitteeResults: Four hundred and ninety-eight patients were admitted to the pediatric intensive care unit, 77 of whom presented exclusion criteria. Thirty-three (7.83%) of the 421 patients studied died and 388 patients were discharged. Estimated mortality by PRISM was 30.84 (7.22%) with a standardized mortality rate of 1.07 (0.74-1.50), z = -0.45 and by PIM this was 26.13 (6.21%) with a standardized mortality rate of 1.26 (0.87-1.77), z = -1.14. The Hosmer-Lemeshow test gave a chi-square of 9.23 (p = 0.100) for PRISM and 27.986 (p < 0.001) for PIM. The area under the ROC curve was 0.870 (0.810-0.930) for PRISM and 0.845 (0.769-0.920) for PIM. The Spearman test returned r = 0.65 (p < 0.001).Conclusion: Analyzing the tests we can observe that, although the PIM test was less well calibrated overall, both PRISM and PIM offer a good capacity for discriminating between survivors and moribund patients. They are tools with comparable performance at the prognostic evaluation of the pediatric patients admitted to our unit. J Pediatr (Rio J). 2005;81(3):259-64: Prognostic scores, PRISM, PIM, mortality.

show abstract

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

et al. 2019

View full text Add to dashboard Cite

IMPORTANCE The global patterns and distribution of case-fatality rates (CFRs) in pediatric severe sepsis and septic shock remain poorly described. OBJECTIVE We performed a systematic review and meta-analysis of studies of children with severe sepsis and septic shock to elucidate the patterns of CFRs in developing and developed countries over time. We also described factors associated with CFRs. DATA SOURCES We searched PubMed, Web of Science, Excerpta Medica database, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane Central systematically for randomized clinical trials and prospective observational studies from earliest publication until January 2017, using the keywords "pediatric," "sepsis," "septic shock," and "mortality." STUDY SELECTION Studies involving children with severe sepsis and septic shock that reported CFRs were included. Retrospective studies and studies including only neonates were excluded. DATA EXTRACTION AND SYNTHESIS We conducted our systematic review and meta-analysis in close accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled case-fatality estimates were obtained using random-effects meta-analysis. The associations of study period, study design, sepsis severity, age, and continents in which studies occurred were assessed with meta-regression. MAIN OUTCOMES AND MEASURES Meta-analyses to provide pooled estimates of CFR of pediatric severe sepsis and septic shock over time. RESULTS Ninety-four studies that included 7561 patients were included. Pooled CFRs were higher in developing countries (31.7% [95% CI, 27.3%-36.4%]) than in developed countries (19.3% [95% CI, 16.4%-22.7%]; P < .001). Meta-analysis of CFRs also showed significant heterogeneity across studies. Continents that include mainly developing countries reported higher CFRs (adjusted odds ratios: Africa, 7.89 [95% CI, 6.02-10.32]; P < .001; Asia, 3.81 [95% CI, 3.60-4.03]; P < .001; South America, 2.91 [95% CI, 2.71-3.12]; P < .001) than North America. Septic shock was associated with higher CFRs than severe sepsis (adjusted odds ratios, 1.47 [95% CI, 1.41-1.54]). Younger age was also a risk factor (adjusted odds ratio, 0.95 [95% CI, 0.94-0.96] per year of increase in age). Earlier study eras were associated with higher CFRs (adjusted odds ratios for 1991-2000, 1.24 [95% CI, 1.13-1.37]; P < .001) compared with 2011 to 2016. Time-trend analysis showed higher CFRs over time in developing countries than developed countries. CONCLUSIONS AND RELEVANCE Despite the declining trend of pediatric severe sepsis and septic shock CFRs, the disparity between developing and developed countries persists. Further characterizations of vulnerable populations and collaborations between developed and developing countries are warranted to reduce the burden of pediatric sepsis globally.

show abstract

Can generic scores (Pediatric Risk of Mortality and Pediatric Index of Mortality) replace specific scores in predicting the outcome of presumed meningococcal septic shock in children?

Cited by 44 publications

References 48 publications

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Comparação entre dois escores de prognóstico (PRISM e PIM) em unidade de terapia intensiva pediátrica

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

Contact Info

Product

Resources

About