Pediatric Intensive Care Unit, Department of Pediatrics, Seth G.S. Medical College and KEM Hospital, Mumbai, India.
Indian J Pediatr. 2010 Mar;77(3):267-71. doi: 10.1007/s12098-010-0031-3. Epub 2010 Feb 22.
To validate Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality (PIM) score.
All consecutive patients over a six month period were included in the study except patients with a PICU stay of less than 2 hours, those transferred to other PICUs, pediatric surgical cases, trauma patients and those dying within 24 hours of admission. The PRISM and PIM scores of all patients included in the study were computed and the outcome was noted in terms of survival or non-survival. Mortality discrimination was quantified by calculating the area under the receiver operating characteristic (ROC) curve. Hosmer and Lemeshow goodness-of-fit test was used to calibrate the scores.
Two hundred and thirty patients were enrolled with mean age of 40.6 months and male to female ratio of 1.2:1. There were 56 deaths (mortality rate 24.3%). The mortality in infants was higher (37.8 %) as compared to non-infants (16.2 %) (p = 0.011). The predicted deaths with PRISM score was 24.3%. The area under the ROC curve was 0.851 (95% CI 0.790-0.912). The Hosmer and Lemeshow goodness-of-fit test showed good calibration (p = 0.627, chi square = 1.75, degree of freedom = 3). The predicted deaths with the PIM score was 7.38%. The area under the ROC curve for PIM score was 0.838 (95 % CI 0.776-0.899). The Hosmer and Lemeshow goodness-of-fit showed a poor calibration for PIM score (p = 0.0281, chi-square = 10.866, degree of freedom = 4).
Both PRISM and PIM scores have a good discriminatory performance. The calibration with PRISM score is good but the PIM score displays poor calibration.
验证儿科病死率预测评分（PRISM）和儿科死亡指数（PIM）评分。
除了 ICU 住院时间少于 2 小时、转往其他 ICU、儿科手术病例、创伤患者和入院后 24 小时内死亡的患者外，研究纳入了在六个月期间内的所有连续患者。计算所有纳入研究的患者的 PRISM 和 PIM 评分，并根据生存或非生存记录结果。通过计算接收者操作特征（ROC）曲线下的面积来量化死亡率的区分能力。采用 Hosmer 和 Lemeshow 拟合优度检验来校准评分。
共纳入 230 例患者，平均年龄为 40.6 个月，男女比例为 1.2:1。有 56 例死亡（死亡率 24.3%）。婴儿的死亡率（37.8%）高于非婴儿（16.2%）（p=0.011）。PRISM 评分预测的死亡人数为 24.3%。ROC 曲线下的面积为 0.851（95%CI 0.790-0.912）。Hosmer 和 Lemeshow 拟合优度检验显示良好的校准（p=0.627，卡方=1.75，自由度=3）。PIM 评分预测的死亡人数为 7.38%。PIM 评分的 ROC 曲线下面积为 0.838（95%CI 0.776-0.899）。Hosmer 和 Lemeshow 拟合优度检验显示 PIM 评分的校准效果较差（p=0.0281，卡方=10.866，自由度=4）。
PRISM 和 PIM 评分均具有良好的区分性能。PRISM 评分的校准效果良好，但 PIM 评分的校准效果较差。
