Performance of pediatric index of mortality-2 scoring system in Tanta University pediatric intensive care unit

Objectives The aim of this study was to validate Pediatric Index of Mortality-2 (PIM-2) and evaluate quality of care in Tanta University pediatric ICU (PICU). Patients and methods This is a prospective cohort study performed in Tanta University Hospital. We studied the patients admitted in the PICU from January 2014 to December 2014. The PIM-2 scoring system was assessed within an hour of infant or child arrival to the PICU. Logistic regression analysis was performed to compare expected mortality risk with observed mortality rate. Receiver operating characteristics curve analysis was performed and standardized mortality ratio was calculated. PIM-2 Index validation was performed using the Hosmer and Lemeshow goodness-of-fit test. Results Two hundred patients were included in this study. The model fit was achieved adequately (P=0.741). The area under the receiver operating characteristics curve was 0.773 (95% confidence interval: 0.65–0.92) and standardized mortality ratio was 1.08. PIM-2 calibrated well using Hosmer Lemeshow analysis (χ2=5.58, P=0.34). The expected incidence of death was 34% and the observed incidence was 37%. The expected/observed ratio is 0.91. Conclusion PIM-2 can be used as a good prediction model for pediatric mortality and as a tool for assessing the overall quality of care in Tanta University PICU. It shows adequate discriminatory function and well calibrated for the case mix of patients in PICU of Tanta, Egypt.