英国儿科重症监护病房儿童死亡率指数的校准
Calibration of the paediatric index of mortality in UK paediatric intensive care units.
作者信息
Pearson G A, Stickley J, Shann F
机构信息
Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
出版信息
Arch Dis Child. 2001 Feb;84(2):125-8. doi: 10.1136/adc.84.2.125.
AIM
To test a paediatric intensive care mortality prediction model for UK use.
METHOD
Prospective collection of data from consecutive admissions to five UK paediatric intensive care units (PICUs), representing a broad cross section of paediatric intensive care activity. A total of 7253 admissions were analysed using tests of the discrimination and calibration of the logistic regression equation.
RESULTS
The model discriminated and calibrated well. The area under the ROC plot was 0.84 (95% CI 0.819 to 0.853). The standardised mortality ratio was 0.87 (95% CI 0.81 to 0.94). There was remarkable concordance in the performance of the paediatric index of mortality (PIM) within each PICU, and in the performance of the PICUs as assessed by PIM. Variation in the proportion of admissions that were ventilated or transported from another hospital did not affect the results.
CONCLUSION
We recommend that UK PICUs use PIM for their routine audit needs. PIM is not affected by the standard of therapy after admission to PICU, the information needed to calculate PIM is easy to collect, and the model is free.
目的
测试一种供英国使用的儿科重症监护死亡率预测模型。
方法
前瞻性收集来自英国五个儿科重症监护病房（PICU）连续入院患者的数据，这些患者代表了儿科重症监护活动的广泛范围。使用逻辑回归方程的判别和校准测试对总共7253例入院患者进行分析。
结果
该模型判别和校准效果良好。ROC曲线下面积为0.84（95%可信区间0.819至0.853）。标准化死亡率为0.87（95%可信区间0.81至0.94）。每个PICU内儿科死亡率指数（PIM）的表现以及通过PIM评估的PICU表现存在显著一致性。通气或从另一家医院转运的入院患者比例的变化不影响结果。
结论
我们建议英国的PICU将PIM用于其常规审计需求。PIM不受入住PICU后治疗标准的影响，计算PIM所需的信息易于收集，且该模型免费。
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