Maria Pilar Arias Lopez1, Ariel L Fernández2, María E Ratto3, Liliana Saligari4, Alejandro Siaba Serrate5, In Ja Ko6, Eduardo Troster7, Eduardo Schnitzler5. 1. Hospital de Niños Dr Ricardo Gutiérrez, CABA, Buenos Aires, Argentina. Electronic address: mpariaslopez@gmail.com. 2. FUNDASAMIN (Fundación para la Salud Materno Infantil), CABA, Buenos Aires, Argentina. 3. Hospital de Niños Sor María Ludovica de La Plata, La Plata, Buenos Aires, Argentina. 4. Hospital Nacional Profesor Alejandro Posadas, Palomar, Buenos Aires, Argentina. 5. Hospital Universitario Austral, Pilar, Buenos Aires, Argentina. 6. Hospital de Niños Dr Ricardo Gutiérrez, CABA, Buenos Aires, Argentina. 7. Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil.
Abstract
PURPOSE: The purpose of this study is to asses the performance of the Pediatric Index of Mortality 2 (PIM2) score in pediatric intensive care units (PICUs) in Latin America. MATERIALS AND METHODS: This is a prospective, observational, multicenter study. We included patients aged 1 month to 16 years old admitted consecutively during 1 year to 34 PICUs in 9 Latin American countries. Discrimination and calibration tests were performed to validate the performance of PIM2 in the entire sample and in different subgroups. RESULTS: A total of 7391 patients were analyzed. Pediatric Index of Mortality 2 predicted 573 deaths, whereas the observed deaths were 663 (P < .001). The area under the receiver operating characteristic curve for the entire population was 0.817 (95% confidence interval, 0.808-0.825). The score showed good discrimination. Instead, calibration was inadequate. The difference between observed and predicted deaths for the entire population and across different risk intervals was statistically significant (χ(2) = 121.87; df = 8; P < .001). Pediatric Index of Mortality 2 did not predict mortality correctly in different diagnostic categories (injury, postoperative, and miscellaneous), in children younger than 12 months, adolescents, and patients with chronic complex conditions. CONCLUSIONS: Pediatric Index of Mortality 2 showed good discrimination, but calibration was inadequate. To use PIM2 for monitoring PICU performance in Latin America, it might be necessary to recalibrate the score locally.
PURPOSE: The purpose of this study is to asses the performance of the Pediatric Index of Mortality 2 (PIM2) score in pediatric intensive care units (PICUs) in Latin America. MATERIALS AND METHODS: This is a prospective, observational, multicenter study. We included patients aged 1 month to 16 years old admitted consecutively during 1 year to 34 PICUs in 9 Latin American countries. Discrimination and calibration tests were performed to validate the performance of PIM2 in the entire sample and in different subgroups. RESULTS: A total of 7391 patients were analyzed. Pediatric Index of Mortality 2 predicted 573 deaths, whereas the observed deaths were 663 (P < .001). The area under the receiver operating characteristic curve for the entire population was 0.817 (95% confidence interval, 0.808-0.825). The score showed good discrimination. Instead, calibration was inadequate. The difference between observed and predicted deaths for the entire population and across different risk intervals was statistically significant (χ(2) = 121.87; df = 8; P < .001). Pediatric Index of Mortality 2 did not predict mortality correctly in different diagnostic categories (injury, postoperative, and miscellaneous), in children younger than 12 months, adolescents, and patients with chronic complex conditions. CONCLUSIONS: Pediatric Index of Mortality 2 showed good discrimination, but calibration was inadequate. To use PIM2 for monitoring PICU performance in Latin America, it might be necessary to recalibrate the score locally.
Authors: Deyanira Quiñónez-López; Daniela Patino-Hernandez; César A Zuluaga; Ángel A García; Oscar M Muñoz-Velandia Journal: Indian J Crit Care Med Date: 2020-11
Authors: María Del P Arias López; Nancy Boada; Analía Fernández; Ariel L Fernández; María E Ratto; Alejandro Siaba Serrate; Eduardo Schnitzler Journal: Pediatr Crit Care Med Date: 2018-12 Impact factor: 3.624
Authors: Daniela Patino-Hernandez; Alba Deyanira Quiñonez López; César Augusto Zuluaga; Ángel Alberto García; Oscar Mauricio Muñoz-Velandia Journal: Rev Bras Ter Intensiva Date: 2020 Oct-Dec
Authors: Christopher M Horvat; Dennis W Simon; Zachary Aldewereld; Idris Evans; Rajesh Aneja; Joseph A Carcillo Journal: J Pediatr (Rio J) Date: 2020-11-23 Impact factor: 2.990