Literature DB >> 23287905

Do interventions in an ICU affect the predictive ability of pediatric index of mortality and pediatric index of mortality-2 scores in a tertiary care hospital?

Jhuma Sankar1, Arnav Chandel, Nand Kishore Dubey, Vishnubhatla Sreenivas, Mari Jeeva Sankar.   

Abstract

OBJECTIVE: Our objective was to evaluate the effect of interventions in the initial period of stabilization (i.e., at 4 hrs) on the predictive ability of Pediatric Index of Mortality and Pediatric Index of Mortality-2 scores and to evaluate their performance in our ICU.
DESIGN: Prospective observational study.
SETTING: PICU of a tertiary care teaching hospital. PATIENTS: Consecutive children aged 2 months to 17 yr admitted to our ICU from June 2010 to July 2011 were included.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: We prospectively recorded the baseline characteristics, variables of Pediatric Index of Mortality and Pediatric Index of Mortality-2 at 1 and 4 hrs after admission, and the outcome data in a predesigned proforma. We compared the performance of the scores at these two time points by calculating their discriminative ability and calibration as measured by the area under curve of the receiver operating characteristic curves and the Hosmer-Lemeshow goodness-of-fit test, respectively.Of the 282 children enrolled, 93 (32.9%) died. The median (interquartile) age of the study patients was 3.5 yr (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis and cardiac and neurological illnesses. The area under curves for Pediatric Index of Mortality at 4 and 1 hrs were 0.73 (95% confidence interval 0.66-0.79) and 0.70 (0.63-0.77), respectively. The corresponding values for Pediatric Index of Mortality-2 were 0.72 (0.66-0.79) and 0.71 (0.64-0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores at both the time points (p > 0.1 for all). The calibration across different age and diagnostic subgroups was also good.
CONCLUSION: Interventions in the first 4 hrs did not affect the predictive ability of Pediatric Index of Mortality and Pediatric Index of Mortality-2 scores. The 4-hr scores may be used in place of the 1-hr score, particularly in units where scoring is not possible with in the 1-hr time frame.

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Mesh:

Year:  2013        PMID: 23287905     DOI: 10.1097/PCC.0b013e31827127cd

Source DB:  PubMed          Journal:  Pediatr Crit Care Med        ISSN: 1529-7535            Impact factor:   3.624


  6 in total

1.  Comparison of Pediatric Risk of Mortality III, Pediatric Index of Mortality 2, and Pediatric Index of Mortality 3 in Predicting Mortality in a Pediatric Intensive Care Unit.

Authors:  Priyamvada Tyagi; Milind S Tullu; Mukesh Agrawal
Journal:  J Pediatr Intensive Care       Date:  2018-10-11

2.  Pattern of in-hospital pediatric mortality over a 3-year period at University teaching hospitals in Iran.

Authors:  Mohammad Amin Fallahzadeh; Sophia T Abdehou; Jafar Hassanzadeh; Fatemeh Fallhzadeh; Mohammad Hossein Fallahzadeh; Leila Malekmakan
Journal:  Indian J Crit Care Med       Date:  2015-06

3.  Use of a Mortality Prediction Model in Children on Mechanical Ventilation: A 5-Year Experience in a Tertiary University Hospital.

Authors:  Waleed H Albuali; Amal A Algamdi; Elham A Hasan; Mohammad H Al-Qahtani; Abdullah A Yousef; Mohammad A Al Ghamdi; Dalal K Bubshait; Mohammed S Alshahrani; Faisal O AlQurashi; Talal A Bou Shahmah; Bassam H Awary
Journal:  J Multidiscip Healthc       Date:  2020-11-11

4.  Pediatric Index of Mortality and PIM2 scores have good calibration in a large cohort of children from a developing country.

Authors:  Jhuma Sankar; Archana Singh; M Jeeva Sankar; Sunil Joghee; Shashikant Dewangan; Nandkishore Dubey
Journal:  Biomed Res Int       Date:  2014-06-15       Impact factor: 3.411

5.  Validation of an Electronic Pediatric Index of Mortality 2 Score in a Mixed Quaternary PICU.

Authors:  Emily L Joyce; Christine M Crana; Jonathan Yabes; John A Kellum
Journal:  Pediatr Crit Care Med       Date:  2020-08       Impact factor: 3.971

6.  [Performance of the Pediatric Index of Mortality 2 in a pediatric intensive care unit].

Authors:  Antônio Lima Netto; Virginia Maria Muniz; Eliana Zandonade; Ethel Leonor Noia Maciel; Rodrigo Nichio Bortolozzo; Nélio Ferreira Costa; Rosane da Silva de Araujo Limongi
Journal:  Rev Bras Ter Intensiva       Date:  2014 Jan-Mar
  6 in total

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