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

Martha, Vanessa Feller; García, Pedro Celiny Ramos; Piva, Jefferson Pedro; Einloft, Paulo Roberto; Bruno, Francisco; Rampon, Viviane

doi:10.1590/s0021-75572005000400014

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…According to a cohort study undertaken at the Pontificia Universidade Católica do Rio Grande do Sul, Hospital São Lucas PICU, the Pediatric Risk of Mortality (PRISM) and the Pediatric Index of Mortality (PIM) scores both offer a good capacity for discriminating between survivors and moribund patients [23].…”

Section: Limitations Of the Various Studies To Address The Questionmentioning

confidence: 99%

Pediatric mortality due to nosocomial infection: a critical approach

Lopes¹,

Goulart²,

Starling³

2007

Braz J Infect Dis

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Nosocomial infection is a frequent event with potentially lethal consequences. We reviewed the literature on the predictive factors for mortality related to nosocomial infection in pediatric medicine. Electronic searches in English, Spanish and Portuguese of the PubMed/MEDLINE, LILACS and Cochrane Collaboration Databases was performed, focusing on studies that had been published from 1996 to 2006. The key words were: nosocomial infection and mortality and pediatrics/neonate/newborn/child/infant/adolescent. The risk factors found to be associated with mortality were: nosocomial infection itself, leukemia, lymphopenia, neutropenia, corticosteroid therapy, multiple organ failure, previous antimicrobial therapy, catheter use duration, candidemia, cancer, bacteremia, age over 60, invasive procedures, mechanical ventilation, transport out of the pediatric intensive care unit, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Burkholderia cepacia infections, acute physiology and chronic health evaluation (APACHE) II scores over 15. Among these factors, the only one that can be minimized is inadequate antimicrobial treatment, which has proven to be an important contributor to hospital mortality in critically-ill patients. There is room for further prognosis research on this matter to determine local differences. Such research requires appropriate epidemiological design and statistical analysis so that pediatric death due to nosocomial infection can be reduced and health care quality improved in pediatric hospitals.

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Section: Limitations Of the Various Studies To Address The Questionmentioning

confidence: 99%

Pediatric mortality due to nosocomial infection: a critical approach

Lopes¹,

Goulart²,

Starling³

2007

Braz J Infect Dis

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“…O fato de o sistema imunológico ser menos eficiente durante os 12 primeiros meses de vida, faz com que o lactente se torne mais suscetível a contrair infecções agudas, com complicações sistêmicas, resultando em um número maior de internações (2) . Quanto às internações, a grande maioria apresentou doenças predominantemente clínicas, dado que foi encontrado em um estudo sobre comparação entre dois escores de prognóstico em UTIP, no Rio Grande do Sul (11) e em estudo desenvolvido em Atenas, na Grécia (10 (2) , enquanto que em um estudo de um ano realizado em uma UTIP, em Santa Catarina, a taxa média de permanência foi de apenas três dias (3) . Outro estudo, realizado na UTIP do Hospital da Pontifícia Universidade Católica do Rio Grande do Sul, refere o tempo médio de internação de 11,6 dias.…”

Section: Introductionunclassified

“…Verificou-se que, entre as crianças admitidas na UTIP neste período, o grupo de doenças que mais levou à internação foram as do aparelho respiratório (41,38%), opostamente a outros estudos que descrevem as maiores causas de internação como sendo cardiopatia (11) e neoplasias (10) . Na UTIP do HUM, as pneumopatias acometeram as crianças do sexo masculino, embora em estudo realizado em Campinas-SP, para verificar os fatores que contribuem com complicações em crianças internadas com pneumonia, o risco de evolução para complicações pulmonares foi quase três vezes maior em crianças do sexo feminino (13) .…”

Section: Introductionunclassified

Caracterização das internações em uma unidade de terapia intensiva pediátrica, de um hospital-escola da região sul do Brasil

Molina¹,

Marcon²,

Uchimura³

et al. 2008

Cienc. Cuid. Saúde

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“…15,16 The objective of this study was to evaluate the impact of admission on the cognitive and functional performance of children admitted to the Pediatric ICU at the Hospital de Clínicas de Porto Alegre (HCPA), by means of application of the POPC and PCPC at admission and at discharge to obtain a delta score, in addition to relating it to the Pediatric Index of Mortality (PIM) at admission 17 and with length of stay in the ICU.…”

mentioning

confidence: 99%

Impacto da internação em unidade de terapia intensiva pediátrica: avaliação por meio de escalas de desempenho cognitivo e global

Alievi¹,

Carvalho²,

Trotta³

et al. 2007

J. Pediatr. (Rio J.)

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Objective: To assess the impact of admission to the pediatric intensive care unit (ICU) at the Hospital de Clínicas de Porto Alegre, RS, Brazil on children's cognitive and global performance.Methods: An observational, longitudinal study of a sequential sample of critically ill children. The following indicators were used: the Pediatric Index of Mortality (PIM), for severity and risk of death at admission, the Pediatric Cerebral Performance Category (PCPC), for cognitive morbidity and the Pediatric Overall Performance Category (POPC), for global morbidity, at admission and at discharge. Morbidity related to the ICU was measured according to the difference between classifications at discharge and at admission (delta scores). The Kruskal-Wallis test was applied.Results: A total of 443 patients were assessed, 54% of whom were male, with a median age of 12 months (IQ 4-45), and a median ICU stay of 4.24 days (IQ 2.4-8). The mortality rate was 6.3%. The median PIM score was 2.36% (IQ 1-7). On admission, 46% of the patients had some degree of cognitive morbidity and 66% had some degree of global morbidity. At discharge there was 60% cognitive morbidity and 86% global morbidity. The assessment of ICUrelated morbidity revealed that 25% of the patients had undergone cognitive changes while 41% had undergone global variations, at discharge compared with admission. Conclusions:Although affected by the elevated degree of morbidity at admission, the impact of the ICU stay was more significant in the global than in the cognitive domain. In the same manner, both risk of death at admission and length of stay had a significant effect on the morbidity of severely ill patients.J Pediatr (Rio J). 2007;83(6): 505-511:Outcome, critical care, pediatric cerebral performance category, pediatric overall performance category, morbidity.

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

Cited by 11 publications

References 27 publications

Pediatric mortality due to nosocomial infection: a critical approach

Pediatric mortality due to nosocomial infection: a critical approach

Caracterização das internações em uma unidade de terapia intensiva pediátrica, de um hospital-escola da região sul do Brasil

Impacto da internação em unidade de terapia intensiva pediátrica: avaliação por meio de escalas de desempenho cognitivo e global

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