Prediction of Outcome of the Children Admitted with Shock in Pediatric Intensive Care Unit
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 3014-3018
AbstractBackground:and objectives: In an intensive care unit setting it is necessary to have a rational and objective way to define and quantify severity of illness. Shock is a major cause of mortality in paediatric age group. This study intends to predict mortality in children admitted with shock using PIM2 and PRISM III scoring systems.
Methods: This study was conducted in PICU of GMC, Bettiah. ll the children beyond neonatal period admitted with clinical features of shock were included in the study. Within the first hour of admission PIM 2 was assessed and at 24 hours PRISM III score was assessed. Patients were followed up and the outcome was measured in the form of survivors and non survivors. Results: A total of 87 cases were studied, in which 70 were survivors and 17 were non survivors. There was no statistical significant difference among non survivors between different age groups (p=0.199). Majority of the survivors and non survivors were males but there was no statistical significant difference between the genders (p=0.437). The observed mortality was 19.55%. PIM 2 and PRISM III estimated mortality as 17.7 % (SMR 1.1) and 20.26% (SMR 0.96) respectively. Both PIM 2 (x2=4.34; p=0.32) and PRISM III (x2=4.79; p=0.24) had good calibration. PIM 2 showed better discrimination (AUC=0.912) than PRISM III (AUC=0.902) in ROC curve. PIM 2 and PRISM III scores revealed positive and significant correlation, with spearman's rank correlation (r= 0.216; p=0.045).
Conclusion: Shock has high mortality in children. PIM 2 and PRISM III have good calibration with good discrimination in predicting mortality. Overall both scores exhibited excellent capacity to discriminate between the survivors and non survivors and can be used as a tool with comparable performance for the prognostic evaluation in children admitted with shock. Because of its simplicity PIM 2, is a better tool for resource limited setting.
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