Article Text
Abstract
Aims: To evaluate the performance of the Paediatric Risk of Mortality (PRISM) score in a population of UK children and to use this score to examine severity of illness adjusted mortality of critically ill children <16 years old in a defined geographical region.
Methods: Observational study of a defined population of critically ill children (<16 years old) admitted to hospitals in the South West Region between 1 December 1996 and 30 November 1998.
Results: Data were collected from 1148 eligible admissions. PRISM was found to perform acceptably in this population. There was no significant difference between the overall number of observed deaths and those predicted by PRISM. Admissions with mortality risk 30% or greater had significantly greater odds ratio for death in general intensive care units compared with the tertiary paediatric intensive care unit.
Conclusions: Children with a high initial risk of mortality based on PRISM score were significantly more likely to survive in a tertiary paediatric intensive care unit than in general intensive care units in this region. However, there was no evidence from this study that admissions with lower mortality risk than 30% had significantly worse mortality in non-tertiary general units than in tertiary paediatric intensive care units.
- intensive care
- hospital mortality
- outcome assessment
- BPA, British Paediatric Association
- ICU, intensive care unit
- PICU, paediatric intensive care unit
- PIM score, Paediatric Index of Mortality score
- PRISM score, Paediatric Risk of Mortality score
- ROC, receiver operator characteristic
- TISS, therapeutic invervention scoring system