1. The importance of mortality risk assessment: Validation of the pediatric index of mortality 3 score
- Author
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Wolfler, Andrea, Osello, Raffaella, Gualino, Jenny, Calderini, Edoardo, Vigna, Gianluca, Santuz, Pierantonio, Amigoni, Angela, Savron, Fabio, Caramelli, Fabio, Rossetti, Emanuele, Cecchetti, Corrado, Corbari, Maurizio, Piastra, Marco, Testa, Raffaele, Coffaro, Giancarlo, Stancanelli, Giusi, Gitto, Eloisa, Amato, Roberta, Prinelli, Federica, Salvo, Ida, Racca, F., Ferrero, F., Zoia, E., Mandelli, A., Montani, C., Prandi, E., Molinaro, S., Biban, P., Pettenazzo, A., Furlan, S., Mondardini, C., Iannella, E., Perrotta, D., Picardo, S., Conti, Giorgio, Genovese, O., Dolcini, Andrea, D Amato, L., Guddo, A. M., Giglio, A. M., Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, G. (ORCID:0000-0002-8566-9365), Dolcini, A., Wolfler, Andrea, Osello, Raffaella, Gualino, Jenny, Calderini, Edoardo, Vigna, Gianluca, Santuz, Pierantonio, Amigoni, Angela, Savron, Fabio, Caramelli, Fabio, Rossetti, Emanuele, Cecchetti, Corrado, Corbari, Maurizio, Piastra, Marco, Testa, Raffaele, Coffaro, Giancarlo, Stancanelli, Giusi, Gitto, Eloisa, Amato, Roberta, Prinelli, Federica, Salvo, Ida, Racca, F., Ferrero, F., Zoia, E., Mandelli, A., Montani, C., Prandi, E., Molinaro, S., Biban, P., Pettenazzo, A., Furlan, S., Mondardini, C., Iannella, E., Perrotta, D., Picardo, S., Conti, Giorgio, Genovese, O., Dolcini, Andrea, D Amato, L., Guddo, A. M., Giglio, A. M., Piastra, Marco (ORCID:0000-0002-3144-8970), Conti, G. (ORCID:0000-0002-8566-9365), and Dolcini, A.
- Abstract
Objective: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU. Design: Retrospective, prospective cohort study. Setting: Seventeen Italian PICUs. Patients: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014. Interventions: None. Measurement and Main Results: Eleven thousand one hundred nine children were enrolled in the study. The mean Pediatric Index of Mortality 2 and 3 values of 4.9 and 3.9, respectively, differed significantly (p 0.05). Overall mortality rate was 3.9%, and the standardized mortality ratio was 0.80 for Pediatric Index of Mortality 2 and 0.98 for Pediatric Index of Mortality 3 (p 0.05). The area under the curve of the receiver operating characteristic curves was similar for Pediatric Index of Mortality 2 and Pediatric Index of Mortality 3. The Hosmer-Lemeshow test was not significant for Pediatric Index of Mortality 3 (p = 0.21) but was highly significant for Pediatric Index of Mortality 2 (p 0.001), which overestimated death mainly in high-risk categories. Conclusions: Mortality indices require validation in each country where it is used. The new Pediatric Index of Mortality 3 score performed well in an Italian population. Both calibration and discrimination were appropriate, and the score more accurately predicted the mortality risk than Pediatric Index of Mortality 2.
- Published
- 2016