Paediatric Index of Mortality 3

Abstract

Paediatric Index of Mortality 3 provides an international standard based on a large contemporary dataset for the comparison of risk-adjusted mortality among children admitted to intensive care.

Performance of the Pediatric Index of Mortality 2 in a pediatric intensive care unit

“…For that reason in 2013, Straney et al published an updated version of the PIM2 known as the PIM3, (7) which was based on an international, multicenter, prospective cohort study conducted in 2010 and 2011. That version formulated a novel stratification of the variables corresponding to recovery from surgical procedures (cardiac surgery with bypass, cardiac surgery without bypass and other surgical procedures) as well as the risk categories, which are currently defined as low-, high- and very high-risk.…”

“…(7) The aim of the present study was to investigate the performance of PIM2 at the PICU of the Hospital Infantil Nossa Senhora da Glória (HINSG) by analyzing its calibration and discrimination.…”

Factors present on admission associated with increased mortality in children admitted to a paediatric intensive care unit (PICU)

“…[2] Admission criteria should therefore assess whether ICU will add value to the patient's overall management and eventual outcome, and consider that a patient's health status, diagnosis and severity of illness all influence his/her risk of death. [3] Social factors determining access to health services include income, location and transport. These all contribute to a delay in presentation, possibly leading to more advanced disease and poorer outcomes.…”

Optimism and no longer foolishness? Haematology/oncology and the PICU

“…Many paediatric intensivists are aware that the paediatric index of mortality (PIM score) [3, 4]—now in its third full iteration (PIM3) [5]—describes a much higher PICU mortality for the same admission physiology amongst haematology/oncology cases than the general PICU population. The terms ‘leukaemia/lymphoma outside of first induction’ or ‘bone marrow transplant recipient’ both represent ‘very high-risk’ diagnoses.…”

“…In 53,112 recent cases, either of these fields carries a fivefold greater risk of death with equivalent severity of organ failure at admission. This is the same tariff as a cardiac arrest preceding PICU admission [5]. …”