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Revista Pan-Amazônica de Saúde

Print version ISSN 2176-6215On-line version ISSN 2176-6223

Abstract

FARIAS, Emmerson Carlos Franco de et al. Performance of the Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality 2 (PIM2) in a tertiary pediatric intensive care unit in the Brazilian Amazon. Rev Pan-Amaz Saude [online]. 2019, vol.10, e201900080.  Epub Dec 02, 2019. ISSN 2176-6215.  http://dx.doi.org/10.5123/s2176-6223201900080.

OBJECTIVE:

To evaluate the performance of the Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality 2 (PIM2) scores in the Tertiary Pediatric Intensive Care Unit (PICU) of the Fundação Santa Casa de Misericórdia do Pará (FSCMPA).

MATERIALS AND METHODS:

A retrospective cohort study was conducted with patients hospitalized in PICU for more than 8 h, from January 2017 to April 2018. Exclusion criteria were: stay longer than 90 days; cardiorespiratory arrest without stability in 12 h; palliative care; and brain death. To calculate score and outcome systems, Standardized Mortality Rate (SMR), calibration, and discrimination variables were used and compared by goodness-of-fit and Receiver Operating Characteristic (ROC) curves, respectively.

RESULTS:

Among the 458 hospitalizations, 429 (93.7%) were included. Overall mortality was 17.5%, with 64.0% under 2 years of age; and 58.7% of those who evolved to death were submitted to mechanical ventilation for more than seven days. The estimated mean probability of death from PRISM was 9.85%, while the mean PIM2 was 14.2%. The SMR was 1.35 (1.26-1.72) for PRISM and 1.23 (1.13-1.58) for PIM2. The area under the ROC curve was 0.89 (95% CI 0.81-0.91) for PRISM and 0.87 (95% CI 0.83-0.91) for PIM2.

CONCLUSION:

In the FSCMPA PICU, PRISM and PIM2 had good calibration and good discriminatory power. The SMR was greater than one.

Keywords : Risk Assessment; Pediatric Intensive Care Units; Prognosis; Mortality; Mortality Score.

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