The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand

Slater, Anthony; Shann, Frank

doi:10.1097/01.pcc.0000138557.31831.65

Cited by 141 publications

(102 citation statements)

References 19 publications

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“…8,28 This may explain why a mortality of at least 50% was associated with an increase in the Sequential Organ Failure Assessment score among adult patients during the first two days in ICU 17 and, in our study, with an increase in the PELOD score during the first four days in PICU (occurring in only 1.8% of our sample). Because the length of stay in a PICU is usually short (median three days in our study), we converted time into discrete day intervals to determine the ideal sequence of measurement of daily PELOD scores.…”

Section: Discussionmentioning

confidence: 51%

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Leteurtre

Duhamel²,

Grandbastien³

et al. 2010

Canadian Medical Association Journal

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Section: Discussionmentioning

confidence: 51%

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Leteurtre

Duhamel²,

Grandbastien³

et al. 2010

Canadian Medical Association Journal

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“…Os desempenhos dos sistemas PRISM e PIM foram algumas vezes comparados pelos próprios autores que desenvolveram os escores 15,[18][19][20] , mas poucas vezes comparados de forma independente. 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 .…”

Section: Introductionunclassified

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

Martha¹,

García²,

Piva³

et al. 2005

J Pediatr (Rio J)

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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.

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“…In our study, PIM2 shows well calibration (p = 0.88 in non survivors and 0.83 in survivors), in contrast to Atiaa [27] [40]. Nether Land calibrated the model and found to be acceptable (X2=4.92, df=8, p=0.77) done by Slater [41]. Also in Spain, the model calibrated well (X2=4.87, df=8, p=0.85) done by Prieto Espunes [39].…”

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confidence: 50%

Usefulness of the Pediatric Index of Mortality 2 in Predicting Mortality Rate in Benha University Pediatric Intensive Care Unit.

Elghaiaty¹,

Sobeih²,

Bayoumy³

2018

IJAR

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Background: little is known about the exact causes of death, and the impact of general risk factors that may complicate the course of critically ill patients. Scoring systems for use in ICUS allow an assessment. Aim of the study: To evaluate the usefulness of PIM2 score in predicting the outcome (mortality rate) in PICU in Benha university hospitals. Methods: This prospective study was conducted on 113 patients admitted to PICU in Benha University Hospitals in pediatric department over a period of six months. All patients aged more than one month up to less than sixteen years old. Pediatric index of mortality 2 was scored for all patients within an hour of admission to PICU using a structured data collection form and then compared with outcome which recorded as death or discharge. Results: Data were collected prospectively as a cohort study upon 11 children admitted to PICU in Benha University hospitals during a six months period. The outcome of the 113 patients included in the study was 77 survivors and 36 non-survivors. Observed death rate was (31.9%) and the predicted mortality rate by PIM2 score was 38.1%. So, the standardized mortality ratio was 0.84 signifying overestimation of mortality rate and/or good performance of our unit. PIM2 discriminated between death and survival well with area under the ROC curve was 0.73 and cutoff value at (-2.99) which is a good discrimination and calibrated well (p = 0.88 in non survivors and 0.83 in survivors). Conclusion: PIM2 applied in our PICU was significantly correlated to mortalities as PICU outcome and showed adequate discriminatory function and well calibrated for the case mix of patients in PICU of Benha University hospitals. So, it can be used as a good predictor of mortality in PICUS.

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The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand

Cited by 141 publications

References 19 publications

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

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

Usefulness of the Pediatric Index of Mortality 2 in Predicting Mortality Rate in Benha University Pediatric Intensive Care Unit.

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