Document Detail

Performance of PRISM (Pediatric Risk of Mortality) score and PIM (Pediatric Index of Mortality) score in a tertiary care pediatric ICU.
MedLine Citation:
PMID:  20177831     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To validate Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality (PIM) score. METHODS: All consecutive patients over a six month period were included in the study except patients with a PICU stay of less than 2 hours, those transferred to other PICUs, pediatric surgical cases, trauma patients and those dying within 24 hours of admission. The PRISM and PIM scores of all patients included in the study were computed and the outcome was noted in terms of survival or non-survival. Mortality discrimination was quantified by calculating the area under the receiver operating characteristic (ROC) curve. Hosmer and Lemeshow goodness-of-fit test was used to calibrate the scores. RESULTS: Two hundred and thirty patients were enrolled with mean age of 40.6 months and male to female ratio of 1.2:1. There were 56 deaths (mortality rate 24.3%). The mortality in infants was higher (37.8 %) as compared to non-infants (16.2 %) (p = 0.011). The predicted deaths with PRISM score was 24.3%. The area under the ROC curve was 0.851 (95% CI 0.790-0.912). The Hosmer and Lemeshow goodness-of-fit test showed good calibration (p = 0.627, chi square = 1.75, degree of freedom = 3). The predicted deaths with the PIM score was 7.38%. The area under the ROC curve for PIM score was 0.838 (95 % CI 0.776-0.899). The Hosmer and Lemeshow goodness-of-fit showed a poor calibration for PIM score (p = 0.0281, chi-square = 10.866, degree of freedom = 4). CONCLUSION: Both PRISM and PIM scores have a good discriminatory performance. The calibration with PRISM score is good but the PIM score displays poor calibration.
Roshani N Taori; Keya R Lahiri; Milind S Tullu
Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2010-02-22
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  77     ISSN:  0973-7693     ISO Abbreviation:  Indian J Pediatr     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  267-71     Citation Subset:  IM    
Pediatric Intensive Care Unit, Department of Pediatrics, Seth G.S. Medical College and KEM Hospital, Mumbai, India.
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MeSH Terms
Child, Preschool
Hospital Mortality*
Infant, Newborn
Intensive Care Units, Pediatric*
Prospective Studies
ROC Curve
Risk Assessment
Severity of Illness Index*

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