Validation of pediatric index of mortality 2 (PIM2) in a single pediatric intensive care unit in Japan

Imamura, Toshihiro; Nakagawa, Satoshi; Goldman, Ran D.; Fujiwara, Takeo

doi:10.1007/s00134-011-2460-5

Cited by 37 publications

(35 citation statements)

References 28 publications

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“…19,21 On the other hand, a Japanese study reported PIM 2 SMR <1 (0.77), which meant the score had overpredicted mortality. 23 The discrimination was evaluated by AUC. Discrimination is considered to be very good for ROC >0.…”

Section: Discussionmentioning

confidence: 99%

The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

Sari

Saputra

Triratna

et al. 2017

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Background For critically ill patients in the pediatric intensive care unit (PICU), a scoring system is helpful for assessing the severity of morbidity and predicting the risk of mortality. The Pediatric Index of Mortality (PIM) 3 score consists of ten easy simple variables, so that the probability of death can be assessed prior to undergoing advanced therapies. The PIM 3 score in inexpensive and comprised of routine laboratory variables performed in PICU patients. In Indonesia, studies to validate the PIM 3 score have been limited. Objective To evaluate the PIM 3 score for predicting the probability of death in the PICU, Dr. Mohammad Hoesin Hospital (MHH), Palembang. Methods A prospective, cohort study was performed in the PICU, MHH, Palembang, from February to April 2016. The PIM 3 score was calculated within 2 hours of patients admission to the PICU by an android calculator application. PIM3 score and mortality were analyzed by Mann-Whitney test; calibration was performed by Hosmer-Lameshow goodness of fit test, discrimination was done by receiver operating characteristic (ROC) curve analysis; and standardized mortality ratio (SMR) was calculated. Results During the study period there were 81 PICU patients, 69 children were included, ranging in age from 1,5 to 187 months. The overall mortality rate was 40,58%. The most common illnesses in our subjects were malignancy (17,4%), post non-thoracic surgery (14,5%), dengue shock syndrome (14,5%), respiratory disease (13%), and neurological disease (11,6%). Subjects' PIM3 scores ranged from 1,02% to 58,84%, with means of 26,08% in non-survivors and 13,05% in survivors. The SMR was 2,24, indicating that death was underpredicted. The AUC of 0,771 (95% CI of 0,651 to 0,891) indicated that the PIM3 score had good discrimination. Conclusion In Mohammad Hoesin Hospital, Palembang, South Sumatera, the PIM 3 can be used to predict mortality in PICU patients, but the score should be multiplied by a factor

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Section: Discussionmentioning

confidence: 99%

The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

Sari

Saputra

Triratna

et al. 2017

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“…In Argentina, Eulmesekian [35] found that the standardized mortality ratio for PIM2 was 0.85. In Japanese PICU, Imamura [36] found that the standardized mortality was 0.77. Atti [29] in Italy found that Standardized mortality ratio was 0.7.…”

Section: Results:-mentioning

confidence: 99%

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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“…8 It is recent, freely available while many other rating tools need a license and in addition, PIM2 has a small number of variables, thus it is easily calculated. 4,9 We aimed in the current study to assess the performance of PIM2, in terms of discriminatory ability and calibration in a sample of Egyptian children admitted to the PICU.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Mortality prediction models are useful in PICU settings as risk assessment tools and as a benchmark for the quality of care between facilities. 4 Prediction tools must discriminate well between survivors and non-survivors and be well calibrated before they can be applied usefully to assess or standardize comparisons of PICUs or to correct for case-mix differences between groups in observational studies. 5 Pediatric Index of Mortality (PIM) was first developed in 1997 6 and as most other prognostic scoring systems, was upgraded to PIM2, which was observed to have better predictability of the outcome of pediatric patients admitted to intensive care.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the performance of the Pediatric Index of Mortality 2 (PIM2) among Egyptian pediatric patients admitted to the intensive care

Youssef

Mosleh

Labib

2014

Egyptian Pediatric Association Gazette

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Background: Mortality prediction models are useful in pediatric intensive care units (PICUs) as risk assessment tools and as a benchmark for the quality of care. Objectives: To assess the performance of the Pediatric Index of Mortality 2 (PIM2) in terms of calibration and discrimination between survivors and non-survivors among pediatric patients. Methods: This is a cohort prospective study including 317 pediatric patients admitted to two PICU settings in a tertiary care hospital in Egypt over a period of one year (from June 2012 till June 2013). Collected data included personal characteristics, hospital data, diagnosis, outcome and variables included in PIM2 scoring. Results: Non-survivors constituted 8.5%. Most common diagnosis was respiratory diseases (47.9%). Only CNS morbidities (11.7% of survivors versus 37% of non-survivors, P = 0.001) and a higher PIM2 score (2.39 ± 5.49 in survivors versus 41.38 ± 36.06 in non-survivors, P = 0.001) were associated with increased risk of non-survival. The area under the curve (AUC) for PIM2 is 0.796 (95% CI 0.675-0.916), P < 0.001. The Hosmer-Lemeshow goodness-of-fit was 2.850, 8 df, P = 0.943. PIM2. Conclusion: The calibration and the discriminative ability of PIM2 scoring system aiming to distinguish survivors from non-survivors are satisfactory for this sample of pediatric patients. PIM2 is easily calculated and is freely available. Thus, this tool provides a good incentive for ICU settings in Egypt for admission of high risk patients in the light of the limited PICU bed complement capacity in relation to the demands.

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Validation of pediatric index of mortality 2 (PIM2) in a single pediatric intensive care unit in Japan

Cited by 37 publications

References 28 publications

The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

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

Assessment of the performance of the Pediatric Index of Mortality 2 (PIM2) among Egyptian pediatric patients admitted to the intensive care

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