May 31, 2006Pediatric Critical Care Medicine110 citations

Performance of Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), and PIM2 in a pediatric intensive care unit in a developing country

ATAnu ThukralAll India Institute of Medical Sciences RLRakesh LodhaNational Institutes of Health MIMohammad IrshadHenry Ford Health System

Structured PICO

Do PRISM, PIM, and PIM2 scoring systems accurately predict mortality in children admitted to an Indian PICU?

Population

215 children admitted to a pediatric intensive care unit (PICU) in India, excluding neonates and those staying <=2 hours.

Intervention

Evaluation of Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), and PIM2 scoring systems

Outcome

Mortality (discriminative ability and calibration of scoring systems)hard clinical

Existing pediatric mortality risk scores (PRISM, PIM, PIM2) show good discrimination but significantly underpredict mortality in a developing country PICU setting.

Abstract

OBJECTIVE: To determine the discriminative ability and calibration of existing scoring systems in predicting the outcome (mortality) in children admitted to an Indian pediatric intensive care unit (PICU). DESIGN: Prospective cohort study. SETTING: Pediatric Intensive Care Unit, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, from July 1, 2002, to July 31, 2003. PATIENTS: A total of 246 patients were admitted. After exclusion of 29 neonates and two patients who stayed in the PICU for 0.8. However, all the models underpredicted mortality. The likely reasons for this could be differences in the patient profile and greater load of severity of illness being managed with lesser resources--both physical and human--and differences in the quality of care.

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