Application of the pediatric risk of mortality (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit

AUTOR(ES)

Costa, Graziela Araujo, Delgado, Arthur F., Ferraro, Alexandre, Okay, Thelma Suely

FONTE

Clinics

DATA DE PUBLICAÇÃO

2010

RESUMO

INTRODUCTION: To establish disease severity at admission can be performed by way of the mortality prognostic. Nowadays the prognostic scores make part of quality control and research. The Pediatric Risk of Mortality is one of the scores used in the pediatric intensive care units. OBJECTIVES: The purpose of this study is the utilization of the pediatric risk of mortality to determine mortality risk factors in a tertiary pediatric intensive care units. METHODS: Retrospective cohort study, in a period of one year, at a general tertiary pediatric intensive care unit. The pediatric risk of mortality scores corresponding to the first 24 hours of hospitalization were recorded; additional data were collected to characterize the study population. RESULTS: 359 patients were included; the variables that were found to be risk factors for death were multiple organ dysfunction syndrome, mechanical ventilation, use of vasoactive drugs, hospital-acquired infection, parenteral nutrition and duration of hospitalization (p < 0,0001). Fifty-four patients (15%) died; median pediatric risk of mortality score was significantly lower in patients who survived (p=0,0001). The ROC curve yielded a value of 0.76 (CI 95% 0,69-0,83) and the calibration was shown to be adequate. DISCUSSION: It is imperative for pediatric intensive care units to implement strict quality controls to identify groups at risk of death and to ensure the adequacy of treatment. Although some authors have shown that the PRISM score overestimates mortality and that it is not appropriate in specific pediatric populations, in this study pediatric risk of mortality showed satisfactory discriminatory performance in differentiating between survivors and non-survivors. CONCLUSIONS: The pediatric risk of mortality score showed adequate discriminatory capacity and thus constitutes a useful tool for the assessment of prognosis for pediatric patients admitted to a tertiary pediatric intensive care units.

Documentos Relacionados

• Aplicação do Pediatric Risk of Mortality escore (PRISM) e determinação dos fatores de prognóstico para óbito em uma unidade de terapia intensiva pediátrica terciária
• Risk Factors for Mortality in Pediatric Cardiac Intensive Care Unit
• Intensive care unit patients on mechanical ventilation at a university hospital in southern Brazil : characteristics, mortality, frequency, and mortality risk factors
• Avaliação do desempenho do escore Pediatric Índex of Mortality II na predição de mortalidade em unidade de terapia intensiva pediátrica
• Evaluation of the prevalence and factors associated with acute kidney injury in a pediatric intensive care unit