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Comparison of two different severity scores (Paediatric Risk of Mortality [PRISM] and the Glasgow Meningococcal
P S Silva1, M C Fonseca, S B Iglesias
1Paediatric Intensive Care Unit, Department of Paediatrics, São Paulo Federal University and Emílio Ribas Infectious Disease Institute, São Paulo, Brazil. psls.nat@terra.com.br
Abstract:
Two different illness severity scores, Pediatric Risk of Mortality (PRISM) and the Glasgow Meningococcal Sepsis Prognostic Score (GMSPS), were evaluated and compared in meningococcal disease in two paediatric intensive care units. Forty-nine children with a median age of 36 months who had meningococcal sepsis confirmed by laboratory data were evaluated. Overall mortality was 18%. The median GMSPS was 3 in survivors and 8 in non-survivors. A GMSPS > or = 8 was significantly associated with death (p = 0.0001) with a mortality predictivity and specificity of 70% and 92.5%, respectively. The median PRISM score in survivors was 5.5 and 23 in non-survivors. A PRISM score of > or = 11 was significantly related to death (p < 0.0001). The Kendal correlation co-efficient between GMSPS and PRISM showed tau = 0.6859 (p = 0.0000). It is concluded that GMSPS and PRISM are useful methods for identifying and classifying children into low and high risk categories. GMSPS > or = 8 or a PRISM score > or = 11 are significantly predictive of mortality.
Insights
The Glasgow Meningococcal Sepsis Prognostic Score (GMSPS) and Pediatric Risk of Mortality (PRISM) effectively identified high-risk children with meningococcal sepsis. Scores of GMSPS ≥ 8 or PRISM ≥ 11 significantly predicted mortality in pediatric intensive care units.
Area of Science:
- Pediatric Intensive Care Medicine
- Infectious Diseases
- Clinical Epidemiology
Background:
- Meningococcal disease is a severe infection in children.
- Accurate assessment of illness severity is crucial for prognosis.
- Existing scoring systems require validation in specific pediatric populations.
Purpose of the Study:
- To compare the effectiveness of the Pediatric Risk of Mortality (PRISM) score and the Glasgow Meningococcal Sepsis Prognostic Score (GMSPS).
- To evaluate their utility in predicting mortality in pediatric patients with meningococcal sepsis.
Main Methods:
- Retrospective evaluation of 49 children with laboratory-confirmed meningococcal sepsis.
- Analysis of GMSPS and PRISM scores in relation to patient outcomes (survival vs. death).
- Statistical comparison of score performance, including correlation and predictive values.
Main Results:
- Overall mortality was 18%.
- GMSPS ≥ 8 (median 8 vs. 3) and PRISM ≥ 11 (median 23 vs. 5.5) were significantly associated with death (p < 0.0001).
- GMSPS showed 70% predictive and 92.5% specific mortality prediction; PRISM also demonstrated significant predictive capability.
Conclusions:
- Both GMSPS and PRISM scores are valuable tools for stratifying pediatric patients with meningococcal sepsis into risk categories.
- Specific score thresholds (GMSPS ≥ 8, PRISM ≥ 11) reliably predict mortality.
- These scores aid in clinical decision-making and resource allocation in pediatric intensive care settings.