Risk adjusted mortality of critical illness in a defined geographical region

Henderson, John; Garland, Lynn; Warne, Siobhan; Bailey, Linda; Weir, Patricia; Edees, Susan

doi:10.1136/adc.86.3.194

Cited by 14 publications

(5 citation statements)

References 18 publications

(10 reference statements)

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“…However, in our study which was retrospective we could not objectively determine the severity of our patients' illness using tools like the Paediatric Risk of Mortality (PRISM) and the Paediatric Index of Mortality (PIM) since they were not applied from the onset. Though several studies have suggested better outcome in critically ill children managed in the PICU as compared with those managed in the general ICU, [3][4][5][6]18] we are yet to develop PICUs in our country and it will be interesting to find out the experiences of other general ICUs in our region with regards to the management of paediatric patients. Authors have reported mortality rates between 2-16% from PICUs in other parts of the world.…”

Section: Discussionmentioning

confidence: 99%

“…Though a report by the British Paediatric Association in 1993 did not show any difference in the outcome between children managed in a dedicated paediatric intensive care unit (PICU) and those managed in a general ICU, [2] subsequent studies by other authors have indicated an improved outcome in critically ill children managed in the PICU. [3][4][5][6] Though general and neonatal ICUs are now commonly found in our country, it is not so with PICUs and so most critically ill children are managed in the general ICUs along with adults. The ICU in our hospital is a general (multidisciplinary) ICU established 27 years ago to cater for critically ill patients of all age groups.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric admissions and outcome in a general intensive care unit

Embu

Yiltok

Isamade

et al. 2011

Afr J Paediatr Surg

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We found an increasing rate of paediatric admissions to our general ICU over the years. We also found a high mortality rate among paediatric patients admitted to our ICU. The poor outcome in paediatric patients managed in our ICU appears to be a reflection of the inadequacy of facilities. Better equipping our ICUs and improved man-power development would improve the outcome for our critically ill children. Hospitals in our region should also begin to look into the feasibility of establishing PICUs in order to further improve the standard of critical care for our children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paediatric admissions and outcome in a general intensive care unit

Embu

Yiltok

Isamade

et al. 2011

Afr J Paediatr Surg

View full text Add to dashboard Cite

show abstract

“…Although this study was not designed to compare outcome, the standardised mortality ratio (SMR) of children managed in the PICU was lower than in adult ICUs, and previous studies of critically ill children have shown that those in the highest risk stratum have a significantly greater risk of dying if treated outside a designated PICU. 5 Interestingly, PIM discriminated better between death and survival in district general hospitals than in the regional PICU. One might speculate that the reason for this closer modelling is because the physiological data necessary for PIM are collected at an earlier time point in the child's hospital course than when the PICU team collects them.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units

Fraser

Maskrey

Taylor³

2004

Archives of Disease in Childhood

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“…In 1988, Pollack et al 6 developed a risk adjustment method, the Paediatric Risk of Mortality (PRISM) score based on acute physiological derangement, to facilitate comparisons of mortality between different populations of critically ill children. Limited multicenter validation 7 has been published and no equivalent studies from India are available.…”

mentioning

confidence: 99%

Estimation of Short-Term Outcomes in Patients Admitted in Picu by Application of a Severity of Illness Score (Prism-Iii Score)

Bhoi¹,

Bhoi²

2018

jemds

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BACKGROUND The concept of Paediatric intensive management is changing rapidly worldwide. But there are no definite parameters available for the assessment of the patient's severity. There was an intense need to conduct study which deals with the assessment of patient but also helps in prognosticating the patient and help in counseling the parents at the time of admission. The severity of sickness is assessed on the basis of PRISM-III Score (Paediatric Risk of Mortality), that is an internationally accepted standard score. MATERIALS AND METHODS The present prospective observational study was carried out during October 2015 to September 2016 in Paediatric Intensive Care Unit (PICU) of Prakash Institute of Medical Sciences and Research, Urun-Islampur. All patients admitted to PICU during October 2015 to September 2016 who fulfilled the inclusion criteria were enrolled in the study. RESULTS Among the physiological parameters BP, GCS and pupils showed statistically significant association with mortality. Heart rate and temperature did not show any significant relation with mortality. Only 4 patients had severe tachycardia as risk factor. We did not find any significant association between these parameters and mortality. Among lab parameters studied, ABG showed significant association with mortality with 64.7% mortality for children with pH less than 7.28. On evaluation of chemistry tests Potassi um, Creatinine and BUN showed good association with mortality. 38.5% mortality for glucose values < 80, which was statistically significant. Based on Haematological tests, PT and PTT showed significant association with mortality. WBC count and platelet count did not show significant association with mortality. CONCLUSION PRISM III score has good predictive value in assessing the probability of mortality.

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Risk adjusted mortality of critical illness in a defined geographical region

Cited by 14 publications

References 18 publications

Paediatric admissions and outcome in a general intensive care unit

Paediatric admissions and outcome in a general intensive care unit

Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units

Estimation of Short-Term Outcomes in Patients Admitted in Picu by Application of a Severity of Illness Score (Prism-Iii Score)

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