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Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia

OBJECTIVE: To assess the performance of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Index of Mortality III (PIM III) indices in a tertiary pediatric intensive care unit (PICU) in Saudi Arabia and to identify the factors affecting the observed performance. DESIGN: Retrospective, sin...

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Autores principales: Alkhalifah, Ahmed S., AlSoqati, Abdulaziz, Zahraa, Jihad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300935/
https://www.ncbi.nlm.nih.gov/pubmed/35874581
http://dx.doi.org/10.3389/fped.2022.926686
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author Alkhalifah, Ahmed S.
AlSoqati, Abdulaziz
Zahraa, Jihad
author_facet Alkhalifah, Ahmed S.
AlSoqati, Abdulaziz
Zahraa, Jihad
author_sort Alkhalifah, Ahmed S.
collection PubMed
description OBJECTIVE: To assess the performance of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Index of Mortality III (PIM III) indices in a tertiary pediatric intensive care unit (PICU) in Saudi Arabia and to identify the factors affecting the observed performance. DESIGN: Retrospective, single-center study using data collected from the Virtual Pediatric Systems web-based database. SETTING: King Fahad Medical City PICU, Saudi Arabia. PATIENTS: All pediatric patients <14 years of age admitted between 1 January 2015, and 31 December 2019. INTERVENTIONS: Comparison of PRISM III and PIM III performances in predicting mortality across different age groups, disease categories, and resuscitation decision statuses. MEASUREMENTS: Normality of distribution was assessed using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Patient characteristics were compared between survivors and non-survivors. The medians and ranges were calculated for continuous data, whereas frequencies and percentages were used for nominal data. The Mann–Whitney U test, Kruskal–Wallis test, and Chi-square test were used to compare the characteristics of survivors and non-survivors. MAIN RESULTS: There was a significant difference between the predicted mortality and observed mortality in both the PRISM III and PIM III. Better discrimination was found after excluding do-not-resuscitate (DNR) patients. The worst calibration and discrimination were recorded for infants <12 months of age. The PRISM III performed significantly better in patients with metabolic/genetic and central nervous system illnesses. Non-DNR patients had a lower standardized mortality rate using the PRISM III and PIM III. The PRISM III and PIM III indices performed better in patients who died within the first week of admission. CONCLUSION: These models had sufficient discrimination ability and poor calibration. Since they were designed for particular patient characteristics and PICUs, further testing in different environments is necessary before utilization for planning and assessing performance. Alternatively, new models could be developed which are suitable for local PICUs.
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spelling pubmed-93009352022-07-22 Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia Alkhalifah, Ahmed S. AlSoqati, Abdulaziz Zahraa, Jihad Front Pediatr Pediatrics OBJECTIVE: To assess the performance of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Index of Mortality III (PIM III) indices in a tertiary pediatric intensive care unit (PICU) in Saudi Arabia and to identify the factors affecting the observed performance. DESIGN: Retrospective, single-center study using data collected from the Virtual Pediatric Systems web-based database. SETTING: King Fahad Medical City PICU, Saudi Arabia. PATIENTS: All pediatric patients <14 years of age admitted between 1 January 2015, and 31 December 2019. INTERVENTIONS: Comparison of PRISM III and PIM III performances in predicting mortality across different age groups, disease categories, and resuscitation decision statuses. MEASUREMENTS: Normality of distribution was assessed using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Patient characteristics were compared between survivors and non-survivors. The medians and ranges were calculated for continuous data, whereas frequencies and percentages were used for nominal data. The Mann–Whitney U test, Kruskal–Wallis test, and Chi-square test were used to compare the characteristics of survivors and non-survivors. MAIN RESULTS: There was a significant difference between the predicted mortality and observed mortality in both the PRISM III and PIM III. Better discrimination was found after excluding do-not-resuscitate (DNR) patients. The worst calibration and discrimination were recorded for infants <12 months of age. The PRISM III performed significantly better in patients with metabolic/genetic and central nervous system illnesses. Non-DNR patients had a lower standardized mortality rate using the PRISM III and PIM III. The PRISM III and PIM III indices performed better in patients who died within the first week of admission. CONCLUSION: These models had sufficient discrimination ability and poor calibration. Since they were designed for particular patient characteristics and PICUs, further testing in different environments is necessary before utilization for planning and assessing performance. Alternatively, new models could be developed which are suitable for local PICUs. Frontiers Media S.A. 2022-07-07 /pmc/articles/PMC9300935/ /pubmed/35874581 http://dx.doi.org/10.3389/fped.2022.926686 Text en Copyright © 2022 Alkhalifah, AlSoqati and Zahraa. 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
Alkhalifah, Ahmed S.
AlSoqati, Abdulaziz
Zahraa, Jihad
Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title_full Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title_fullStr Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title_full_unstemmed Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title_short Performance of Pediatric Risk of Mortality III and Pediatric Index of Mortality III Scores in Tertiary Pediatric Intensive Unit in Saudi Arabia
title_sort performance of pediatric risk of mortality iii and pediatric index of mortality iii scores in tertiary pediatric intensive unit in saudi arabia
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300935/
https://www.ncbi.nlm.nih.gov/pubmed/35874581
http://dx.doi.org/10.3389/fped.2022.926686
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