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意大利儿童死亡率指数2评分:一项多中心、前瞻性、观察性研究。

Pediatric Index of Mortality 2 score in Italy: a multicenter, prospective, observational study.

作者信息

Wolfler Andrea, Silvani Paolo, Musicco Massimo, Salvo Ida

机构信息

Department of Anesthesia and Intensive Care, Children's Hospital Vittore Buzzi, Istituti Clinici di Perfezionamento, Via Castelvetro 32, 20154 Milan, Italy.

出版信息

Intensive Care Med. 2007 Aug;33(8):1407-13. doi: 10.1007/s00134-007-0694-z. Epub 2007 Jun 5.

Abstract

OBJECTIVES

To assess the performance of the Pediatric Index of Mortality (PIM) 2 score in Italian pediatric intensive care units (PICUs).

DESIGN

Prospective, observational, multicenter, 1-year study.

SETTING

Eighteen medical-surgical PICUs.

PATIENTS

Consecutive patients (3266) aged 0-16 years admitted between 1 March 2004 and 28 February 2005.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

To assess the performance of the PIM2 score, discrimination and calibration measures were applied to all children admitted to the 18 PICUs, in the entire population and in different groups divided for deciles of risk, age and admission diagnosis. There was good discrimination, with an area under the receiver operating characteristic (ROC) curve of 0.89 (95% CI 0.86-0.91) and good calibration of the scoring system [non-significant differences between observed and predicted deaths when the population was stratified according to deciles of risk (chi2 9.86; 8 df, p = 0.26) for the whole population].

CONCLUSIONS

The PIM2 score performed well in this sample of the Italian pediatric intensive care population. It may need to be reassessed in the injury and postoperative groups in larger studies.

摘要

目的

评估儿童死亡指数(PIM)2评分在意大利儿科重症监护病房(PICU)中的表现。

设计

前瞻性、观察性、多中心、为期1年的研究。

地点

18个内科-外科PICU。

患者

2004年3月1日至2005年2月28日期间收治的0至16岁连续患者(3266例)。

干预措施

无。

测量指标及主要结果

为评估PIM2评分的表现,对18个PICU收治的所有儿童,在总体人群以及按风险、年龄和入院诊断十分位数划分的不同组中应用了区分度和校准度测量方法。区分度良好,受试者操作特征(ROC)曲线下面积为0.89(95%CI 0.86 - 0.91),评分系统校准度良好[当总体人群按风险十分位数分层时,观察到的死亡与预测死亡之间无显著差异(χ2 9.86;8自由度,p = 0.26)]。

结论

PIM2评分在意大利儿科重症监护人群的这个样本中表现良好。在更大规模研究中的损伤和术后组可能需要重新评估。

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