Comparison of PRISM IV and PIM III prognostic scores as mortality indicators among paediatric intensive care unit patients  

Q4 Medicine
Mukund Vaja, Shashank Jain, Pradhyumn Pamecha, Ashutosh Singh Rathore, Anushka Aggarwal, Kiran Kumar Jain, Manan Arora
{"title":"Comparison of PRISM IV and PIM III prognostic scores as mortality indicators among paediatric intensive care unit patients\n ","authors":"Mukund Vaja, Shashank Jain, Pradhyumn Pamecha, Ashutosh Singh Rathore, Anushka Aggarwal, Kiran Kumar Jain, Manan Arora","doi":"10.4038/sljch.v52i3.10527","DOIUrl":null,"url":null,"abstract":"Introduction: Identifying prognosis of patients admitted in the paediatric intensive care unit (PICU) is of paramount importance to better allocate medical resources, reduce patient-doctor conflict and for overall better patient care. Many scoring systems have been formulated to accomplish this task including paediatric risk of mortality (PRISM) IV and paediatric index of mortality (PIM) III.Objectives: To compare PRISM IV and PIM III as prognostic scoring tools in the PICU of a tertiary healthcare centreMethod: This prospective observational study was conducted in the PICU, Dhiraj hospital, SBKS MI&RC, Gujarat, India, from March 2021 to September 2022. It included all patients from age 1 month to 18 years who were admitted in the PICU for >24 hours and gave consent for this study. They were thoroughly examined and investigations were done within the first hour of admission as per standard guidelines and their PRISM IV and PIM III scores were calculated and data were analysed.Results: A total of 74 patients was enrolled in this study. Whilst 43 (58.1%) patients were discharged, 18 (24.3%)] were discharged against medical advice(DAMA) moribund, 4 were DAMA (non-moribund) and 9 (12.2%) died. Receiver Operating Characteristic (ROC) curves were made for both PRISM IV and PIM III scores. Discriminatory powers of PIM III (AUC 0.725; 95% CI: 0.609 to 0.823) and PRISM IV (AUC 0.8; 95% CI: 0.691 to 0.884) were acceptable. Whilst PRISM IV was the better predictor of mortality at cut off point of >4 with area under curve of 0.8 for correctly predicting mortality, this difference was not statistically significant (p value=0.354). Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.Conclusions: Both PRISM IV and PIM III were good prognostic scoring tools in the PICU of the tertiary healthcare centre. Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.","PeriodicalId":38870,"journal":{"name":"Sri Lanka Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sri Lanka Journal of Child Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4038/sljch.v52i3.10527","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Identifying prognosis of patients admitted in the paediatric intensive care unit (PICU) is of paramount importance to better allocate medical resources, reduce patient-doctor conflict and for overall better patient care. Many scoring systems have been formulated to accomplish this task including paediatric risk of mortality (PRISM) IV and paediatric index of mortality (PIM) III.Objectives: To compare PRISM IV and PIM III as prognostic scoring tools in the PICU of a tertiary healthcare centreMethod: This prospective observational study was conducted in the PICU, Dhiraj hospital, SBKS MI&RC, Gujarat, India, from March 2021 to September 2022. It included all patients from age 1 month to 18 years who were admitted in the PICU for >24 hours and gave consent for this study. They were thoroughly examined and investigations were done within the first hour of admission as per standard guidelines and their PRISM IV and PIM III scores were calculated and data were analysed.Results: A total of 74 patients was enrolled in this study. Whilst 43 (58.1%) patients were discharged, 18 (24.3%)] were discharged against medical advice(DAMA) moribund, 4 were DAMA (non-moribund) and 9 (12.2%) died. Receiver Operating Characteristic (ROC) curves were made for both PRISM IV and PIM III scores. Discriminatory powers of PIM III (AUC 0.725; 95% CI: 0.609 to 0.823) and PRISM IV (AUC 0.8; 95% CI: 0.691 to 0.884) were acceptable. Whilst PRISM IV was the better predictor of mortality at cut off point of >4 with area under curve of 0.8 for correctly predicting mortality, this difference was not statistically significant (p value=0.354). Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.Conclusions: Both PRISM IV and PIM III were good prognostic scoring tools in the PICU of the tertiary healthcare centre. Multivariate logistic regression analysis showed that the duration of stay(days) and PRISM IV value >4 were significant independent risk factors of mortality after adjusting for confounding factors.
PRISM IV和PIM III预后评分作为儿科重症监护病房患者死亡率指标的比较
引言:确定儿科重症监护室(PICU)住院患者的预后对于更好地分配医疗资源、减少医患冲突和全面改善患者护理至关重要。已经制定了许多评分系统来完成这项任务,包括儿科死亡率(PRISM)IV和儿科死亡率指数(PIM)III。目的:比较PRISM IV和PIM III作为三级医疗中心PICU的预后评分工具,2021年3月至2022年9月。它包括所有1个月至18岁的患者,这些患者在PICU住院超过24小时,并同意本研究。他们在入院后的第一个小时内按照标准指南进行了彻底检查和调查,并计算了他们的PRISM IV和PIM III评分并分析了数据。结果:本研究共纳入74例患者。43名(58.1%)患者出院,18名(24.3%)患者在临终时违反医嘱出院,4名患者为非临终患者,9名(12.2%)患者死亡。为PRISM IV和PIM III评分绘制受试者工作特性(ROC)曲线。PIM III(AUC 0.725;95%CI:0.609-0.823)和PRISM IV(AUC 0.8;95%CI:0.691-0.84)的判别力是可接受的。PRISM IV是在临界点>4时死亡率的更好预测因子,曲线下面积为0.8,多因素logistic回归分析显示,在校正混杂因素后,住院时间(天)和PRISM IV值>4是显著的死亡率独立危险因素。结论:PRISM IV和PIM III都是三级医疗中心PICU的良好预后评分工具。多因素logistic回归分析显示,在校正混杂因素后,住院时间(天)和PRISM IV值>4是显著的死亡率独立危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Sri Lanka Journal of Child Health
Sri Lanka Journal of Child Health Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.30
自引率
0.00%
发文量
101
审稿时长
24 weeks
期刊介绍: This is the only journal of child health in Sri Lanka. It is designed to publish original research articles and scholarly articles by recognized authorities on paediatric subjects. It is distributed widely in Sri Lanka and bears the ISSN number 1391-5452 for the print issues and e-ISSN 2386-110x for the electronic version in the internet. The journal is published quarterly and the articles are reviewed by both local and foreign peers. The Journal is the primary organ of Continuing Paediatric Medical Education in Sri Lanka.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信