死亡率儿科指数的表现 PIM-3 在印度的三级护理 PICU 中
Nisha Toteja1, Bharat Choudhary2, Daisy Khera3
1Department of Pediatrics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Journal of pediatric intensive care
|December 4, 2024
概括
儿科死亡率指数-3 (PIM-3) 评分显示了儿童重症监护病房死亡率的强有力的预测能力. 然而,在一个发展中国家,它的校准很差.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
- 临床流行病学临床流行病学
背景情况:
- 儿科死亡率指数-3 (PIM-3) 是用于儿科重症监护的广泛使用的评分系统.
- 对于PIM-3在资源有限的环境中的实用性存在担忧.
- 需要特定区域的数据来评估不同人群和医疗保健限制的PIM-3绩效.
研究的目的:
- 评估PIM-3得分在预测死亡率方面的表现.
- 评估PIM-3在发展中国家的三级护理儿科重症监护室 (PICU) 的准确性.
主要方法:
- 追溯队列研究,包括1个月至18岁的儿童入院PICU.
- 收集的数据包括人口统计,疾病概况,并发症,PIM-3分数和结果.
- 统计分析涉及受体运行特征 (AUROC) 曲线下的区间进行歧视和标准化死亡率 (SMR) 用Hosmer-Lemes显示适合校准的良性.
主要成果:
- 总共包括282名儿童,其中62人 (21.9%) 死亡.
- PIM-3得分显示出优异的歧视,AUROC为0.961.
- 然而,PIM-3得分的校准不佳,正如Hosmer-Lemeshow测试 (χ2 = 11.7,p < 0.05) 和1.28的SMR所表明的那样.
结论:
- PIM-3评分具有强大的歧视力,可以预测PICU中的死亡率.
- 尽管有良好的歧视,但PIM-3得分在发展中国家的第三级护理PICU的背景下表现不佳.
- 可能需要进一步的研究来完善或适应对资源有限的设置的评分系统.
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