AIMS: To assess the impact of two paediatric intensive care unit retrieval teams on the performance of three mortality risk scoring systems: pre-ICU PRISM, PIM, and PRISM II. METHODS: A total of 928 critically ill children retrieved for intensive care from district general hospitals in the south east of England (crude mortality 7.8%) were studied. RESULTS: Risk stratification was similar between the two retrieval teams for scores utilising data primarily prior to ICU admission (pre-ICU PRISM, PIM), despite differences in case mix. The fewer variables required for calculation of PIM resulted in complete data collection in 88% of patients, compared to pre-ICU PRISM (24%) and PRISM II (60%). Overall, all scoring systems discriminated well between survival and non-survival (area under receiver operating characteristic curve 0.83-0.87), with no differences between the two hospitals. There was a tendency towards better discrimination in all scores for children compared to infants and neonates, and a poor discrimination for respiratory disease using pre-ICU PRISM and PRISM II but not PIM. All showed suboptimal calibration, primarily as a consequence of mortality over prediction among the medium (10-30%) mortality risk bands. CONCLUSIONS: PIM appears to offer advantages over the other two scores in terms of being less affected by the retrieval process and easier to collect. Recalibration of all scoring systems is needed.
AIMS: To assess the impact of two paediatric intensive care unit retrieval teams on the performance of three mortality risk scoring systems: pre-ICU PRISM, PIM, and PRISM II. METHODS: A total of 928 critically ill children retrieved for intensive care from district general hospitals in the south east of England (crude mortality 7.8%) were studied. RESULTS: Risk stratification was similar between the two retrieval teams for scores utilising data primarily prior to ICU admission (pre-ICU PRISM, PIM), despite differences in case mix. The fewer variables required for calculation of PIM resulted in complete data collection in 88% of patients, compared to pre-ICU PRISM (24%) and PRISM II (60%). Overall, all scoring systems discriminated well between survival and non-survival (area under receiver operating characteristic curve 0.83-0.87), with no differences between the two hospitals. There was a tendency towards better discrimination in all scores for children compared to infants and neonates, and a poor discrimination for respiratory disease using pre-ICU PRISM and PRISM II but not PIM. All showed suboptimal calibration, primarily as a consequence of mortality over prediction among the medium (10-30%) mortality risk bands. CONCLUSIONS:PIM appears to offer advantages over the other two scores in terms of being less affected by the retrieval process and easier to collect. Recalibration of all scoring systems is needed.
Authors: Regina Grigolli Cesar; Bibiane Ramos Pinheiro Bispo; Priscilla Helena Costa Alves Felix; Maria Carolina Caparica Modolo; Andreia Aparecida Freitas Souza; Nelson K Horigoshi; Alexandre T Rotta Journal: J Pediatr Intensive Care Date: 2020-04-17
Authors: Chris Feudtner; James E Levin; Rajendu Srivastava; Denise M Goodman; Anthony D Slonim; Vidya Sharma; Samir S Shah; Susmita Pati; Crayton Fargason; Matt Hall Journal: Pediatrics Date: 2009-01 Impact factor: 7.124
Authors: Gijs D Vos; Annemieke C Nissen; Fred H M Nieman; Mieke M B Meurs; Dick A van Waardenburg; Graham Ramsay; Raymond A M G Donckerwolcke Journal: Intensive Care Med Date: 2003-11-15 Impact factor: 17.440
Authors: Stéphane Leteurtre; Francis Leclerc; Jessica Wirth; Odile Noizet; Eric Magnenant; Ahmed Sadik; Catherine Fourier; Robin Cremer Journal: Crit Care Date: 2004-05-21 Impact factor: 9.097