The Importance of Mortality Risk Assessment: Validation of the Pediatric Index of Mortality 3 Score.
Pediatr Crit Care Med
; 17(3): 251-6, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26825046
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 MAINRESULTS:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Unidades de Terapia Intensiva Pediátrica
/
Indicadores Básicos de Saúde
/
Mortalidade Hospitalar
/
Medição de Risco
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article