Mironov P I, Aleksandrovich Iu S, Ivanov D O, Kuznetsova I V, Lekmanov A U
Anesteziol Reanimatol. 2009 Jan-Feb(1):22-5.
The aim of this study was to estimate the validity of pediatric severity rating scales at general pediatric intensive care units. This was a prospective, observational multicenter study that was performed from November 1, 2007, to January 31, 2008. The end points were the estimation of the severity of disease, by using the PRISM, PIM II, RELOD scores, and 28-day survival. The investigation covered 226 patients whose mean age was 4.1 +/- 0.3 years. Twelve (5.3%) patients died during the study. The Medcalc computer program was employed for statistical analysis. The area under the receiver operating curve (ROC) was 0.623 +/- 0.116 for PRISM (p = 0.289); 0641 +/- 0.116 for PELOD (p = 0.224); 0.833 +/- 0.096 for PIM II (p < 0.001). The calibration of scores according to the intervals of mortality risk (Hosmer-Lemeshov test) showed that the observed and predicted mortality rates were similar for PIM II scores (chi2 = 8.23; p = 0.084) and were different for PRISM scores (chi2 = 203.5; p < 0.001) and PELOD ones (chi2 = 26.16; p < 0.001). Thus, the PIM II scores showed the best validity. PRISM and PELOD can be used to estimate the severity of disease in individual subgroups of high mortality-risk patients.
本研究的目的是评估儿科重症监护病房中儿科严重程度评分量表的有效性。这是一项前瞻性观察性多中心研究，于2007年11月1日至2008年1月31日进行。终点指标为使用PRISM、PIM II、RELOD评分评估疾病严重程度以及28天生存率。该调查涵盖了226例平均年龄为4.1±0.3岁的患者。12例（5.3%）患者在研究期间死亡。采用Medcalc计算机程序进行统计分析。PRISM的受试者工作特征曲线（ROC）下面积为0.623±0.116（p = 0.289）；PELOD为0.641±0.116（p = 0.224）；PIM II为0.833±0.096（p < 0.001）。根据死亡风险区间对评分进行校准（Hosmer-Lemeshov检验）显示，PIM II评分的观察死亡率和预测死亡率相似（χ2 = 8.23；p = 0.084），而PRISM评分（χ2 = 203.5；p < 0.001）和PELOD评分（χ2 = 分）的观察死亡率和预测死亡率不同。因此，PIM II评分显示出最佳有效性。PRISM和PELOD可用于评估高死亡风险患者个体亚组中的疾病严重程度。 26.16；p < 0.001）。因此，PIM II评分显示出最佳有效性。PRISM和PELOD可用于评估高死亡风险患者个体亚组中的疾病严重程度。
