Abstract:

Aim: Scoring systems that predict the risk of mortality for children in an intensive care unit (ICU) are needed for evaluation of the effectiveness of pediatric intensive care. The Pediatric Risk of Mortality (PRISM) and the Pediatric Index of Mortality (PIM) scores have been developed to predict mortality among children in ICU. The purpose of this study was to evaluate whether these systems are effective and appropriate for our ICU patient population. Methods: PRISM and PIM scores were caiculated prospectively during a one-year period on solely non-surgical 105 infants admitted to the ICU. Statistical analysis was performed to assess the performance of the scoring systems. Results: There were 29 (27.6 %) deaths and 76 (72.4 %) survivors. SMR and Z scores for PIM and PRISM signified higher mortality and poor performance. Mortality prediction by the scoring systems appeared to be underestimated in almost all risk groups. The Hosmer and Lemeshow test showed a satisfactory overall calibration of both scoring systems. Although ROC analysis showed a poor discriminatory function of both scores, a marginally acceptable performance for PIM was observed. ROC curue also showed an acceptable performance for PIM in patients with pre-existent chronic disorder. Conclusion: Although care must be taken not to overstate the importance of our results, we think that when revised according to the characteristics of the population, PIM may yield a favorable performance in predicting the mortality risk for infants in ICU, especially in countries where the mortality rate is relatively higher and pre-existent chronic disorders are more common.

Keywords: