Assessment of the Pediatric Index of Mortality (PIM) and the Pediatric Risk of Mortality (PRISM) III score for prediction of mortality in a paediatric intensive care unit in Hong Kong

KMS Choi, DKK Ng, SF Wong, KL Kwok, PY Chow, CH Chan, JCS Ho
Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong

OBJECTIVE. To compare two models (The Pediatric Risk of Mortality III score and Pediatric Index of Mortality) for prediction of mortality in a paediatric intensive care unit in Hong Kong.

DESIGN. Prospective case series.

SETTING. A five-bed paediatric intensive care unit in a general hospital in Hong Kong.

PATIENTS. All patients consecutively admitted to the unit between April 2001 and March 2003.

MAIN OUTCOME MEASURES. Scores for both models compared with observed mortality.

RESULTS. A total of 303 patients were admitted to the paediatric intensive care unit during the study period. The median age was 2 years, with an interquartile range of 7 months to 7 years. The male to female ratio was 169:134 (55.8%:44.2%). The median length of hospital stay was 3 days. The overall predicted number of deaths using The Pediatric Risk of Mortality III score was 10.2 patients whereas that by Pediatric Index of Mortality was 13.2 patients. The observed mortality was eight patients. The area under the receiver operating characteristics curve for the two models was 0.910 and 0.912, respectively.

CONCLUSION. The predicted mortality using both prediction models correlated well with the observed mortality.

Hong Kong Med J 2005;11:97-103

Key words: Child; Intensive care units, pediatric; Mortality; Predictive value of tests; Severity of illness index