PRISM III score predicted mortality with excellent accuracy (AUC 0.984), outperforming PIM 2 (AUC 0.836) and PELOD (AUC 0.872), in pediatric ICU patients in India with 20.3% observed mortality.
Observational (n=138)
No
Do PRISM III, PIM 2, and PELOD scores accurately predict mortality in pediatric intensive care unit patients?
In a resource-constrained PICU setting, the PRISM III score provided superior mortality risk prediction and discrimination compared to PIM 2 and PELOD.
Effect estimate: AUC 0.984 for PRISM III vs 0.836 PIM 2 and 0.872 PELOD
Absolute Event Rate: 20.3% vs 20.3%
p-value: PRISM III vs PIM 2 p=0.0021; PRISM III vs PELOD p=0.0008
Aim: To assess and compare Pediatric Risk of Mortality III (PRISM III), Pediatric Index of Mortality 2 (PIM 2), and Pediatric Logistic Organ Dysfunction (PELOD) scores for predicting mortality in a pediatric intensive care unit (PICU) setting. Design and setting: A cross-sectional, hospital-based, analytical observational study conducted in an eight-bed PICU. Methods: PICU patients between the ages of 1 month and 17 years fulfilling the inclusion criteria were included in this study. PIM 2 score was calculated within the first hour of admission; PRISM III and PELOD scores were calculated at 24 hours. Outcomes of survival or non-survival were recorded. Scoring system performance was assessed using indices of discrimination and calibration. Predictive accuracy for mortality was evaluated with receiver operating characteristic (ROC) curve analysis, and calibration between predicted and observed mortality was examined using the Hosmer-Lemeshow goodness-of-fit test. Results: Data from 138 patients were analyzed (M: F=0.8:1) with a mean age of 62.5 months and a median of 24 months. Respiratory ailments were the highest (46.4%), followed by central nervous system diseases (18.1%), and overall mortality was 20.3%. Area under the ROC curve was 0.984 for PRISM III, 0.836 for PIM 2, and 0.872 for PELOD. PRISM III was a better predictor of mortality risk, followed by PIM 2 and PELOD. The goodness-of-fit test showed good calibration for all three scores, but PRISM III had the better power compared to PIM 2 and PELOD. Conclusion: In our PICU setting, the PRISM III score was a better predictor of mortality risk, and the performance of PELOD was the least.
Sengupta et al. (2026) conducted an observational in Pediatric intensive care unit patients aged 1 month to 17 years admitted to medical PICU in South Gujarat, India (n=138). PRISM III score vs. PIM 2 score and PELOD score was evaluated on Mortality prediction accuracy in PICU patients (AUC 0.984 for PRISM III vs 0.836 PIM 2 and 0.872 PELOD, p=PRISM III vs PIM 2 p=0.0021; PRISM III vs PELOD p=0.0008). PRISM III score predicted mortality with excellent accuracy (AUC 0.984), outperforming PIM 2 (AUC 0.836) and PELOD (AUC 0.872), in pediatric ICU patients in India with 20.3% observed mortality.