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Mortality risk prediction by application of pediatric risk of mortality scoring system in pediatric intensive care
Ali Khajeh1, Noor Mohammad Noori1, Mohsen Reisi1
1Department of Pediatrics, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Iran.
Insights
The Pediatric Risk of Mortality (PRISM) score effectively predicts mortality in pediatric intensive care units (PICUs). Higher PRISM scores correlate with increased mortality risk, demonstrating its value in patient assessment.
Area of Science:
- Pediatric critical care medicine
- Clinical epidemiology
- Biostatistics
Background:
- The Pediatric Risk of Mortality (PRISM) score is a widely used tool for assessing mortality risk in pediatric intensive care units (PICUs).
- Accurate prediction of mortality is crucial for effective patient management and resource allocation in PICUs.
Purpose of the Study:
- To evaluate the efficacy of the PRISM score in predicting mortality rates among pediatric patients admitted to the PICU.
- To assess the correlation between PRISM score levels and in-hospital mortality.
Main Methods:
- A cohort study involving 221 children admitted to the PICU over an 18-month period.
- Calculation of PRISM scores and mortality risk for each patient.
- Analysis using Kaplan-Meier curves, ROC curves, Log Rank (Mantel-Cox) test, and Logistic regression model.
Main Results:
- A total of 47 deaths occurred during the study period.
- Mortality rates increased significantly with higher PRISM scores (10.2% for scores 0-10 to 73.8% for scores 21-30).
- The area under the ROC curve was 80.3%, indicating good predictive accuracy for the PRISM score.
Conclusions:
- The PRISM score demonstrates strong predictive capability for mortality risk in the PICU setting.
- The study confirms the utility of the PRISM score as a valuable tool for clinicians managing critically ill children.
Objective:
The Pediatric Risk of Mortality (PRISM) score is one of the scores used by many pediatricians for prediction of the mortality risk in the pediatric intensive care unit (PICU). Herein, we intend to evaluate the efficacy of PRISM score in prediction of mortality rate in PICU.
Methods:
In this cohort study, 221 children admitted during an 18-month period to PICU, were enrolled. PRISM score and mortality risk were calculated. Follow up was noted as death or discharge. Results were analyzed by Kaplan-Meier curve, ROC curve, Log Rank (Mantel-Cox), Logistic regression model using SPSS 15.
Findings:
Totally, 57% of the patients were males. Forty seven patients died during the study period. The PRISM score was 0-10 in 71%, 11-20 in 20.4% and 21-30 in 8.6%. PRISM score showed an increase of mortality from 10.2% in 0-10 score patients to 73.8% in 21-30 score ones. The survival time significantly decreased as PRISM score increased (P≤0.001). A 7.2 fold mortality risk was present in patients with score 21-30 compared with score 0-10. ROC curve analysis for mortality according to PRISM score showed an under curve area of 80.3%.
Conclusion:
PRISM score is a good predictor for evaluation of mortality risk in PICU.
