PRISM score evaluation to predict outcome in pediatric patients on admission at an emergency department

Area of Science:

• Pediatric Critical Care Medicine
• Emergency Medicine
• Health Outcomes Research

Background:

• Accurate prediction of mortality risk in critically ill pediatric patients is essential for effective resource allocation and patient management.
• The Pediatric Risk of Mortality (PRISM) score is a widely used tool, but its utility in specific settings requires validation.

Purpose of the Study:

• To evaluate the predictive accuracy of the PRISM score for patient outcomes in the Intensive Care Area of the Emergency Department.
• To assess the sensitivity, specificity, and efficiency of the PRISM score in a Mexican pediatric population.

Main Methods:

• A prospective evaluation of 100 consecutive critically ill pediatric patients admitted to the Instituto Nacional de Pediatría Emergency Department.
• PRISM scores were calculated, and a logistic regression model was used to compare expected mortality with observed mortality.
• Sensitivity, specificity, and efficiency were determined using a cut-off of r = 0.

Main Results:

• Patients who did not survive had significantly higher PRISM scores (25.8 +/- 14) compared to survivors (8.7 +/- 7.2) (p < 0.001).
• The observed mortality (11 deaths) closely matched the expected mortality (12.91 deaths) based on the PRISM score.
• High sensitivity (1.0), specificity (0.98), and efficiency (0.98) were achieved, demonstrating strong predictive performance.

Conclusions:

• The PRISM score is an objective and efficient tool for predicting mortality risk in critically ill pediatric patients in this setting.
• The score aids in epidemiological assessment and can support clinical decision-making regarding ICU admissions.
• Findings support the consistent application of the PRISM score for risk stratification and patient care optimization.