Key result
The intrinsic surgical risk score (AUROC 0.925) performed better than the PRAm score (AUROC 0.856) for predicting 30-day mortality in paediatric patients, though both yielded many false positives.
Why the study?
The study was conducted to externally validate and recalibrate two patient-specific risk scores for 30-day in-hospital mortality in paediatric patients: the Pediatric Risk Assessment score and the intrinsic surgical risk score.
Do the PRAm and intrinsic surgical risk scores accurately predict 30-day in-hospital mortality in paediatric patients?
Population
606 488 paediatric patients across 56 US and Dutch hospitals
Comparison
Pediatric Risk Assessment (PRAm) score vs intrinsic surgical risk score
Design
International multi-institutional registry-based external validation study
Follow-up
30 days
Authors
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External validation shows limited accuracy and high false positives; leaves open need for refined pediatric perioperative mortality models.
Observational (n=606,488)
Yes
Do the PRAm and intrinsic surgical risk scores accurately predict 30-day in-hospital mortality in paediatric patients?
Effect estimate: AUROC 0.925 (95% CI 0.914-0.936)
While the intrinsic surgical risk score outperformed the PRAm score for predicting 30-day mortality in pediatric patients, both scores had high false positive rates and offered limited clinical benefit over ASA physical status alone.
Tangel et al. (2024) conducted an observational in Paediatric patients requiring surgery (n=606,488). Pediatric Risk Assessment (PRAm) score and intrinsic surgical risk score was evaluated on 30-day in-hospital mortality (AUROC 0.925, 95% CI 0.914-0.936). The intrinsic surgical risk score (AUROC 0.925) performed better than the PRAm score (AUROC 0.856) for predicting 30-day mortality in paediatric patients, though both yielded many false positives.
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