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Risk adjusted mortality of critical illness in a defined geographical region
A J Henderson1, L Garland, S Warne
1Institute of Child Health, Bristol Royal Hospital for Children, Bristol, UK. a.j.henderson@bris.ac.uk
Archives of Disease in Childhood
|February 28, 2002
Summary
The Paediatric Risk of Mortality (PRISM) score accurately predicted outcomes for critically ill UK children. High-risk children had better survival rates in specialized paediatric intensive care units.
Area of Science:
- Pediatric critical care medicine
- Healthcare outcomes research
- Clinical risk stratification
Background:
- The Paediatric Risk of Mortality (PRISM) score is a tool used to assess the severity of illness in critically ill children.
- Evaluating the performance of risk scores in diverse populations is crucial for accurate mortality prediction.
Purpose of the Study:
- To assess the performance of the PRISM score in a UK pediatric population.
- To analyze severity-adjusted mortality rates among critically ill children (<16 years) in a specific UK region.
Main Methods:
- Observational study design.
- Inclusion of critically ill children (<16 years) admitted to hospitals in the South West Region, UK.
- Data collection over a two-year period (December 1996 - November 1998).
Main Results:
- The PRISM score demonstrated acceptable performance within this UK pediatric cohort.
- Observed mortality rates closely matched PRISM-predicted mortality.
- Children with a PRISM score indicating ≥30% mortality risk had higher odds of death in general ICUs compared to tertiary pediatric ICUs.
Conclusions:
- Critically ill children with high predicted mortality (PRISM ≥30%) experienced better survival in tertiary pediatric ICUs than in general ICUs.
- No significant difference in mortality risk was observed for children with lower predicted mortality (<30%) between general and tertiary pediatric ICUs.