{"title":"将 pSOFA 与 PRISM III 和 PIM 2 作为三级护理儿科重症监护病房的预后指标进行比较：一项前瞻性横断面研究。","authors":"Shipra Agrwal, Romit Saxena, Mridna Jha, Urmila Jhamb, Pallavi","doi":"10.5005/jp-journals-10071-24772","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims and background: </strong>Severity scores are used to predict the outcome of children admitted to the intensive care unit. A descriptive score such as the pediatric sequential organ failure assessment (pSOFA) may be useful for prediction of outcome. This study was planned to compare the pSOFA score with these well-studied scores for prediction of mortality.</p><p><strong>Materials and methods: </strong>This prospective cross-sectional study was conducted at the pediatric intensive care units (PICU) of a tertiary care hospital. Children aged from 1 month to 12 years were enrolled sequentially. The pediatric index of mortality (PIM 2) score was calculated within 1 hour, and pediatric risk of mortality (PRISM) III and pSOFA scores were calculated within 24 hours of PICU admission. The pediatric sequential organ failure assessment score was recalculated after 72 hours. The primary outcome variable was hospital mortality, and secondary outcome variables were duration of PICU stay, need for mechanical ventilation, and occurrence of acute kidney injury (AKI). Appropriate statistical tests were used.</p><p><strong>Results: </strong>About 151 children with median (IQR) age of 36 (6, 84) months were enrolled. Mechanical ventilation was required in 87 (57.6%) children. Mortality was 21.2% at 28 days. The median (IQR) predicted mortality using PRISM III and PIM 2 score were 3.4 (1.5%, 11%) and 8.2 (3.1%, 16.6%) respectively. Area under ROC for prediction of mortality was highest for pSOFA 72 with a cut-off of 6.5 having sensitivity of 83.3% and specificity of 76.9%.</p><p><strong>Conclusion: </strong>The pSOFA score calculated at admission and at 72 hours had a better predictive ability for the PICU mortality compared to PRISM III and PIM 2 score.</p><p><strong>How to cite this article: </strong>Agrwal S, Saxena R, Jha M, Jhamb U, Pallavi. Comparison of pSOFA with PRISM III and PIM 2 as Predictors of Outcome in a Tertiary Care Pediatric ICU: A Prospective Cross-sectional Study. Indian J Crit Care Med 2024;28(8):796-801.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 8","pages":"796-801"},"PeriodicalIF":1.5000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372669/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of pSOFA with PRISM III and PIM 2 as Predictors of Outcome in a Tertiary Care Pediatric ICU: A Prospective Cross-sectional Study.\",\"authors\":\"Shipra Agrwal, Romit Saxena, Mridna Jha, Urmila Jhamb, Pallavi\",\"doi\":\"10.5005/jp-journals-10071-24772\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims and background: </strong>Severity scores are used to predict the outcome of children admitted to the intensive care unit. A descriptive score such as the pediatric sequential organ failure assessment (pSOFA) may be useful for prediction of outcome. This study was planned to compare the pSOFA score with these well-studied scores for prediction of mortality.</p><p><strong>Materials and methods: </strong>This prospective cross-sectional study was conducted at the pediatric intensive care units (PICU) of a tertiary care hospital. Children aged from 1 month to 12 years were enrolled sequentially. The pediatric index of mortality (PIM 2) score was calculated within 1 hour, and pediatric risk of mortality (PRISM) III and pSOFA scores were calculated within 24 hours of PICU admission. The pediatric sequential organ failure assessment score was recalculated after 72 hours. The primary outcome variable was hospital mortality, and secondary outcome variables were duration of PICU stay, need for mechanical ventilation, and occurrence of acute kidney injury (AKI). Appropriate statistical tests were used.</p><p><strong>Results: </strong>About 151 children with median (IQR) age of 36 (6, 84) months were enrolled. Mechanical ventilation was required in 87 (57.6%) children. Mortality was 21.2% at 28 days. The median (IQR) predicted mortality using PRISM III and PIM 2 score were 3.4 (1.5%, 11%) and 8.2 (3.1%, 16.6%) respectively. Area under ROC for prediction of mortality was highest for pSOFA 72 with a cut-off of 6.5 having sensitivity of 83.3% and specificity of 76.9%.</p><p><strong>Conclusion: </strong>The pSOFA score calculated at admission and at 72 hours had a better predictive ability for the PICU mortality compared to PRISM III and PIM 2 score.</p><p><strong>How to cite this article: </strong>Agrwal S, Saxena R, Jha M, Jhamb U, Pallavi. Comparison of pSOFA with PRISM III and PIM 2 as Predictors of Outcome in a Tertiary Care Pediatric ICU: A Prospective Cross-sectional Study. Indian J Crit Care Med 2024;28(8):796-801.</p>\",\"PeriodicalId\":47664,\"journal\":{\"name\":\"Indian Journal of Critical Care Medicine\",\"volume\":\"28 8\",\"pages\":\"796-801\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372669/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-10071-24772\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/31 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10071-24772","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/31 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的和背景：严重程度评分用于预测入住重症监护室的儿童的预后。儿科序贯器官衰竭评估（pSOFA）等描述性评分可能有助于预测预后。本研究计划将 pSOFA 评分与这些经过充分研究的评分进行比较，以预测死亡率：这项前瞻性横断面研究在一家三级医院的儿科重症监护室（PICU）进行。年龄在 1 个月至 12 岁之间的儿童按顺序被纳入研究。儿科死亡指数（PIM 2）评分在入院 1 小时内计算，儿科死亡风险（PRISM）III 和 pSOFA 评分在入院 24 小时内计算。儿科序贯器官衰竭评估评分在 72 小时后重新计算。主要结果变量为住院死亡率，次要结果变量为PICU住院时间、机械通气需求和急性肾损伤（AKI）发生率。采用了适当的统计检验：结果：共招募了约 151 名患儿，中位数（IQR）年龄为 36（6，84）个月。87名儿童（57.6%）需要进行机械通气。28 天的死亡率为 21.2%。使用 PRISM III 和 PIM 2 评分预测的死亡率中位数（IQR）分别为 3.4（1.5%，11%）和 8.2（3.1%，16.6%）。pSOFA 72 预测死亡率的 ROC 下面积最大，临界值为 6.5，灵敏度为 83.3%，特异度为 76.9%：结论：与 PRISM III 和 PIM 2 评分相比，入院时和 72 小时内计算的 pSOFA 评分对 PICU 死亡率的预测能力更强：Agrwal S, Saxena R, Jha M, Jhamb U, Pallavi.pSOFA 与 PRISM III 和 PIM 2 作为三级护理儿科重症监护病房预后指标的比较：一项前瞻性横断面研究。Indian J Crit Care Med 2024;28(8):796-801.
Comparison of pSOFA with PRISM III and PIM 2 as Predictors of Outcome in a Tertiary Care Pediatric ICU: A Prospective Cross-sectional Study.
Aims and background: Severity scores are used to predict the outcome of children admitted to the intensive care unit. A descriptive score such as the pediatric sequential organ failure assessment (pSOFA) may be useful for prediction of outcome. This study was planned to compare the pSOFA score with these well-studied scores for prediction of mortality.
Materials and methods: This prospective cross-sectional study was conducted at the pediatric intensive care units (PICU) of a tertiary care hospital. Children aged from 1 month to 12 years were enrolled sequentially. The pediatric index of mortality (PIM 2) score was calculated within 1 hour, and pediatric risk of mortality (PRISM) III and pSOFA scores were calculated within 24 hours of PICU admission. The pediatric sequential organ failure assessment score was recalculated after 72 hours. The primary outcome variable was hospital mortality, and secondary outcome variables were duration of PICU stay, need for mechanical ventilation, and occurrence of acute kidney injury (AKI). Appropriate statistical tests were used.
Results: About 151 children with median (IQR) age of 36 (6, 84) months were enrolled. Mechanical ventilation was required in 87 (57.6%) children. Mortality was 21.2% at 28 days. The median (IQR) predicted mortality using PRISM III and PIM 2 score were 3.4 (1.5%, 11%) and 8.2 (3.1%, 16.6%) respectively. Area under ROC for prediction of mortality was highest for pSOFA 72 with a cut-off of 6.5 having sensitivity of 83.3% and specificity of 76.9%.
Conclusion: The pSOFA score calculated at admission and at 72 hours had a better predictive ability for the PICU mortality compared to PRISM III and PIM 2 score.
How to cite this article: Agrwal S, Saxena R, Jha M, Jhamb U, Pallavi. Comparison of pSOFA with PRISM III and PIM 2 as Predictors of Outcome in a Tertiary Care Pediatric ICU: A Prospective Cross-sectional Study. Indian J Crit Care Med 2024;28(8):796-801.
期刊介绍：
Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
