Publication: Application of Pediatric Risk of Mortality (PRISM) III Score in Predicting Mortality Outcomes
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Health Research Council
Abstract
Abstract
Background: Children admitted in a pediatric intensive care unit have a high risk of mortality. Pediatric risk of mortality III score in first 24 hours of admission has increasingly been used to predict mortality. The objective of this study was to evaluate the validity of Pediatric risk of mortality score in prediction of mortality among the patient admitted in pediatric intensive care unit.
Methods: This prospective observational study was conducted at pediatric intensive care unit of a government pediatric hospital from January to June 2021. Patients between 1 month to 14 years of age and meeting the inclusion criteria were enrolled. Pediatric risk of mortality III score was calculated within 24 hours of admission. Patients were followed up for outcome measure as survivors and non survivors. Chi square test and logistic regression analysis were used to find the association of predictors and the score.
Results: The mean Pediatric risk of mortality III score was lower in survivors than in non-survivors (4.67 ± 3.8 versus 14.10 ± 6.07; p<0.001). Those requiring inotropic and ventilator support have significantly higher mortality [49.4 versus 0.6 (p<0.001) and 81.8 versus 1.5 (p<0.001) respectively]. Minimum systolic blood pressure, abnormal pupillary reflex, increased blood urea nitrogen and decreased platelet were the significant (p<0.001) risk factors. The area under the Receiver Operating Characteristic curve was 0.916±0.024 (p<0.001) and goodness-of-fit test showed no significant difference between observed and expected mortalities (p=0.186).
Conclusions: The Pediatric risk of mortality score constitutes a useful prognostic tool in predicting the mortality.
Key words: Mortality; pediatrics; pediatric intensive care unit; risk score,
Description
Prakash Joshi
Department of Pediatric Medicine, Kanti Childrens Hospital, Maharajgunj, Kathmandu, Nepal
Sumit Agrawal
Department of Pediatric Medicine, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal
https://orcid.org/0000-0002-9863-9325
Jagat Jeevan Ghimire
Department of Pediatric Medicine, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal
https://orcid.org/0000-0002-7513-712X
Pun Narayan Shrestha
Department of Pediatric Medicine, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal
https://orcid.org/0000-0001-5856-4640
Najala Khatun
Department of Pediatric Medicine, Kanti Children’s Hospital, Maharajgunj, Kathmandu, Nepal
Megha Raj Banjara
Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
https://orcid.org/0000-0002-5024-6127