Key result
The PIM3 and PELOD-2 models showed good discrimination for predicting mortality in pediatric ICU patients (AUC 82.4% and 80.3%), while PRISM III showed moderate discrimination (AUC 77.3%).
Why the study?
PRISM III, PIM3, and PELOD-2 are widely used to predict pediatric mortality, but their comparative predictive ability in medical and surgical ICUs needed evaluation.
How do the PRISM III, PIM3, and PELOD-2 models compare in predicting mortality among pediatric patients admitted to medical or surgical ICUs?
Observational (n=90)
How do the PRISM III, PIM3, and PELOD-2 models compare in predicting mortality among pediatric patients admitted to medical or surgical ICUs?
PRISM III, PIM3, and PELOD-2 are all well-calibrated and perform moderately to well in predicting mortality for pediatric patients in medical and surgical ICUs.
These scores may aid mortality risk stratification in mixed pediatric ICUs; further validation in larger cohorts is needed before routine adoption.
Background: The pediatric risk of mortality (PRISM III), pediatric index of mortality (PIM3), and pediatric logistic organ dysfunction (PELOD-2) are of the most used predictive models in predicting the risk of mortality in the pediatric intensive care unit (PICU). Objectives: The current study aimed at comparing the predictive ability of these three modes in medical/surgical ICUs (MICU/SICU). Methods: A total of 90 consecutive patients, aged ⤠18 years, admitted to MICUs or SICUs were enrolled in the current observational, prospective study. The PRISM III, PIM3, and PELOD-2 as well as demographic characteristics of the subjects were recorded on admission. A receive operator characteristic (ROC) curve, logistic regression, and the Hosmer-Lemeshow goodness-of-fit test were used for statistical analyses [95% confidence interval (CI)]. Results: Data analysis showed a significant difference in PRISM III, PIM3, and PELOD-2 scores between survivors and nonsurvivors (P < 0.001, P < 0.001, P < 0.001, respectively). The discrimination power was moderate for PRISM III (area under ROC curve (AUC): 77.3%; standard error (SE): 6.0%), and good for PIM3 and PELOD-2 (AUC: 82.4%, SE: 5.5% and AUC: 80.3%, SE: 4.9%, respectively). All the three models were well calibrated (Ï2 = 4.73, P = 0.79; Ï2 = 3.09, P = 0.93; and Ï2 = 5.01, P = 0.66, respectively). Conclusions: PRISM III, PIM3, and PELOD-2 had good performance in predicting outcomes in children admitted to MICUs or SICUs. Further studies on different ICUs may provide more conclusive results with greater generalization of the validity of these predictive models.
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Ramazani et al. (2019) conducted an observational in Pediatric intensive care admission (n=90). PRISM III, PIM3, and PELOD-2 predictive models was evaluated on Risk of mortality (AUC 77.3% (PRISM III), 82.4% (PIM3), 80.3% (PELOD-2), p=<0.001). The PIM3 and PELOD-2 models showed good discrimination for predicting mortality in pediatric ICU patients (AUC 82.4% and 80.3%), while PRISM III showed moderate discrimination (AUC 77.3%).
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