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The Importance of Mortality Risk Assessment: Validation of the Pediatric Index of Mortality 3 Score.
- Source :
-
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2016 Mar; Vol. 17 (3), pp. 251-6. - Publication Year :
- 2016
-
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.<br />Design: Retrospective, prospective cohort study.<br />Setting: Seventeen Italian PICUs.<br />Patients: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014.<br />Interventions: None.<br />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.<br />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.
Details
- Language :
- English
- ISSN :
- 1529-7535
- Volume :
- 17
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
- Publication Type :
- Academic Journal
- Accession number :
- 26825046
- Full Text :
- https://doi.org/10.1097/PCC.0000000000000657