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Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China
Objective: The performances of the pediatric risk of mortality score III (PRISM III), pediatric logistic organ dysfunction score-2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in Chinese patients are unclear. This study aimed to assess the performances of these scores in predic...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8113391/ https://www.ncbi.nlm.nih.gov/pubmed/33996681 http://dx.doi.org/10.3389/fped.2021.626165 |
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author | Zhang, Lidan Wu, Yuhui Huang, Huimin Liu, Chunyi Cheng, Yucai Xu, Lingling Tang, Wen Luo, Xuequn |
author_facet | Zhang, Lidan Wu, Yuhui Huang, Huimin Liu, Chunyi Cheng, Yucai Xu, Lingling Tang, Wen Luo, Xuequn |
author_sort | Zhang, Lidan |
collection | PubMed |
description | Objective: The performances of the pediatric risk of mortality score III (PRISM III), pediatric logistic organ dysfunction score-2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in Chinese patients are unclear. This study aimed to assess the performances of these scores in predicting mortality in critically ill pediatric patients. Methods: This retrospective observational study was conducted at two tertiary-care PICUs of teaching hospitals in China. A total of 1,253 critically ill pediatric patients admitted to the two Pediatric Intensive Care Units (PICUs) of the First Affiliated Hospital, Sun Yat-Sen University from August 2014 to December 2019 and Shen-Zhen Children's Hospital from January 2019 to December 2019 were analyzed. The indexes of discrimination and calibration were applied to evaluate score performance for the three models (PRISM III, PELOD-2, and P-MODS scores). The receiver operating characteristic (ROC) curve was plotted, and the efficiency of PRISM III, PELOD-2, and P-MODS in predicting death were evaluated by the area under ROC curve (AUC). Hosmer–Lemeshow goodness-of-fit test was used to evaluate the degree of fitting between the mortality predictions of each scoring system and the actual mortality. Results: A total of 1,253 pediatric patients were eventually enrolled in this study (median age, 38 months; overall mortality rate, 8.9%; median length of PICU stay, 8 days). Compared to the survival group, the non-survival group showed significantly higher PRISM III, PELOD-2, and P-MODS scores [PRISM III: 18 (12, 23) vs. 11 (0, 16); PELOD-2, 8 (4, 10) vs. 4 (0, 6); and P-MODS: 5 (4, 9) vs. 3 (0, 4), all P < 0.001]. ROC curve analysis showed that the AUCs of PRISM III, PELOD-2, and P-MODS for predicting the death of critically ill children were 0.858, 0.721, and 0.596, respectively. Furthermore, in the Hosmer–Lemeshow goodness-of-fit test, PRISM III and PELOD-2 showed the better calibration between predicted mortality and observed mortality (PRISM III: χ(2) = 5.667, P = 0.368; PELOD-2: χ(2) = 9.582, P = 0.276; P-MODS: χ(2) = 12.449, P = 0.015). Conclusions: PRISM III and PELOD-2 can discriminate well between survivors and non-survivors. PRISM III and PELOD-2 showed the better calibration between predicted and observed mortality, while P-MODS showed poor calibration. |
format | Online Article Text |
id | pubmed-8113391 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81133912021-05-13 Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China Zhang, Lidan Wu, Yuhui Huang, Huimin Liu, Chunyi Cheng, Yucai Xu, Lingling Tang, Wen Luo, Xuequn Front Pediatr Pediatrics Objective: The performances of the pediatric risk of mortality score III (PRISM III), pediatric logistic organ dysfunction score-2 (PELOD-2), and pediatric multiple organ dysfunction score (P-MODS) in Chinese patients are unclear. This study aimed to assess the performances of these scores in predicting mortality in critically ill pediatric patients. Methods: This retrospective observational study was conducted at two tertiary-care PICUs of teaching hospitals in China. A total of 1,253 critically ill pediatric patients admitted to the two Pediatric Intensive Care Units (PICUs) of the First Affiliated Hospital, Sun Yat-Sen University from August 2014 to December 2019 and Shen-Zhen Children's Hospital from January 2019 to December 2019 were analyzed. The indexes of discrimination and calibration were applied to evaluate score performance for the three models (PRISM III, PELOD-2, and P-MODS scores). The receiver operating characteristic (ROC) curve was plotted, and the efficiency of PRISM III, PELOD-2, and P-MODS in predicting death were evaluated by the area under ROC curve (AUC). Hosmer–Lemeshow goodness-of-fit test was used to evaluate the degree of fitting between the mortality predictions of each scoring system and the actual mortality. Results: A total of 1,253 pediatric patients were eventually enrolled in this study (median age, 38 months; overall mortality rate, 8.9%; median length of PICU stay, 8 days). Compared to the survival group, the non-survival group showed significantly higher PRISM III, PELOD-2, and P-MODS scores [PRISM III: 18 (12, 23) vs. 11 (0, 16); PELOD-2, 8 (4, 10) vs. 4 (0, 6); and P-MODS: 5 (4, 9) vs. 3 (0, 4), all P < 0.001]. ROC curve analysis showed that the AUCs of PRISM III, PELOD-2, and P-MODS for predicting the death of critically ill children were 0.858, 0.721, and 0.596, respectively. Furthermore, in the Hosmer–Lemeshow goodness-of-fit test, PRISM III and PELOD-2 showed the better calibration between predicted mortality and observed mortality (PRISM III: χ(2) = 5.667, P = 0.368; PELOD-2: χ(2) = 9.582, P = 0.276; P-MODS: χ(2) = 12.449, P = 0.015). Conclusions: PRISM III and PELOD-2 can discriminate well between survivors and non-survivors. PRISM III and PELOD-2 showed the better calibration between predicted and observed mortality, while P-MODS showed poor calibration. Frontiers Media S.A. 2021-04-28 /pmc/articles/PMC8113391/ /pubmed/33996681 http://dx.doi.org/10.3389/fped.2021.626165 Text en Copyright © 2021 Zhang, Wu, Huang, Liu, Cheng, Xu, Tang and Luo. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Zhang, Lidan Wu, Yuhui Huang, Huimin Liu, Chunyi Cheng, Yucai Xu, Lingling Tang, Wen Luo, Xuequn Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title | Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title_full | Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title_fullStr | Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title_full_unstemmed | Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title_short | Performance of PRISM III, PELOD-2, and P-MODS Scores in Two Pediatric Intensive Care Units in China |
title_sort | performance of prism iii, pelod-2, and p-mods scores in two pediatric intensive care units in china |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8113391/ https://www.ncbi.nlm.nih.gov/pubmed/33996681 http://dx.doi.org/10.3389/fped.2021.626165 |
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