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Comparison of Performance of the Pediatric Index of Mortality (PIM)-2 and PIM-3 Scores in the Pediatric Intensive Care Unit of a High Complexity Institution

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ID Minciencias: ART-0000034410-3
Ranking: ART-ART_B

Abstract:

To determine the performance of each of the available pediatric index of mortality (PIM) scores, by assessing the capability for discrimination and calibration in patients admitted to a pediatric intensive care unit in Bogotá.We designed a retrospective, observational cohort study, which included all patients aged between a month and 17 years and 364 days, admitted to the pediatric intensive care unit of a high complexity university hospital between April 1, 2016 and December 31, 2018. We analyzed the standardized mortality ratio, discrimination, calibration, and net reclassification index (NRI) for each model.A total of 722 patients were included, the mortality rate was 3.74%, and for PIM-3, the ratio between expected and observed mortality was 0.66 [confidence interval (CI) 0.40-1.05] for PIM-2 and 1.00 (CI 0.59-1.68) for PIM-3. The Hosmer-Lemeshow (HL) test suggests inadequate calibration for PIM-2 (HL = 13.18, p = 0.11) and adequate calibration for PIM-3 (HL = 28.08, p < 0.01). The area under the diagnostic performance curves for PIM-2 and PIM-3 were 0.87 (95% CI 0.80-0.94) and 0.89 (95% CI 0.82-0.95), respectively. The NRI was -27.1%. PIM-3 classified survivors better than PIM-2, but inadequately classified nonsurvivors.Although both models show adequate discrimination ability, PIM-3 shows a better correlation between predicted risk score and observed mortality. Thus, it may be a useful tool for measuring the internal processes of intensive care units in Colombia and for making comparisons between groups of similar characteristics.Quiñónez-López D, Patino-Hernandez D, Zuluaga CA, García ÁA, Muñoz-Velandia OM. Comparison of Performance of the Pediatric Index of Mortality (PIM)-2 and PIM-3 Scores in the Pediatric Intensive Care Unit of a High Complexity Institution. Indian J Crit Care Med 2020;24(11):1095-1102.

Tópico:

Sepsis Diagnosis and Treatment

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Información de la Fuente:

SCImago Journal & Country Rank
FuenteIndian Journal of Critical Care Medicine
Cuartil año de publicaciónNo disponible
Volumen24
Issue11
Páginas1095 - 1102
pISSNNo disponible
ISSN0972-5229

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