Abstract
Aim: Our aim was to estimate the prediction of mortality by application of Pediatric Risk of Mortality (PRISM) score in a tertiary care pediatric intensive care unit (PICU) patients.
Methods: 225 children admitted to the PICU of a tertiary care hospital over a period of 24 months were enrolled in this cross-sectional observational study. PRISM III score was estimated using variables after admission in first 24 hours. The outcome was defined as survivors and deceased.
Results: Of 225 patients, 44 died and 181 survived. By PRISM score 49 children had the score of 1-9. 45 patients had PRISM score of <15, Maximum number of cases (113 patients) had PRISM score between 16-30, 29 patients had a prism score ranging from 31-45 and 38 cases had a high PRISM score of >45. The recovery rate was 100% in the first group (scores <15), 99% in the second group (score 16-30) while 75.86% recovery was seen in the 3rd group (score 31-45) and only 5.26% in the fourth group (scores > 45). The proportion of deaths which was only 1% among children with the PRISM scores of 16-30, showed a gradual increase with increase in score value, reaching 94.7 % among the children with a PRISM scores of > 45 .
Conclusion: PRISM score has good predictive value in assessing the probability of mortality in relation to children admitted to a pediatric intensive care unit.
References
- Sarathi M, Lodha R, Vivekanandhan S, Arora NK. Adrenal status in children with septic shock using low-dose stimulation test. Peditr Crit Care. 2007; 8:23-8.
- Bryce J, Boschi-Pinto C, Shibuya K, Black RE.WHO child health epidemiology reference group.WhO estimates of the causes of death in children. Lancet 2005; 365:1147-52.
- Global Health Observatory (GHO) data.www.who.int
- Gomke RJBJ, Bonsel GJ, Johannes Van Vught A. Effectiveness and efficiency of a Dutch Pediatric intensiveCare unit: Validity and application of the Pediatric Risk of mortality score. Critical Care Med 1994; 2:1477-1484.
- Bhadoria Poonam, Bhagwat Amit. Severity Scoring Systems in Paediatric Intensive Care Units. Indian Journal of Anaesthesia 2008;52:Suppl(5):663-675
- Singhal D, Kumar, J. M. Puliyel, S. K. Singh, V. Srinivas. Prediction of mortality by application of PRISM score in Intensive care unit. Indian Paediatrics 2001Jul;38(7):714-9.
- Ahmed El-Nawawy. Evaluation of the outcome of patients admitted to PICU in Alexandria using the PRISM score. Journal of tropical paediatrics 2003 Apr;49(2):109-14..
- Mehta J et al. PRISM III score as predictor of mortality in a paediatric intensive care unit of a tertiary care hospital.Journal of Paediatric Critical care. 2016 ;3 (4): 16-19.
- Anthony RB, David H, Stephanie B, Sam J, Kathy R, Gale P, et al. assessment and optimization of mortality prediction tools for admissions to pediatric intensive care in the united kingdom. pediatrics. 2006; 117(e733).
- Pollack MM, Kantilal M Patel, Urs E Ruttiman. PRISM III: An updated pediatric risk of mortality Score. CritCare Med 1996; 24: 743-752.
- Bilan N. Risk of mortality in PICU, assessed by PRISM score. Pakistan Journal of Biological Sciences2009;12(6): 480-487.
- Mukthar FR.A study on the prediction of illness related mortality of critically ill children by applying paediatric risk of mortality III score in paediatric medical intensive care unit patient. Sri Lanka Journal of Child Health, 2018; 47(2):118-124.
- Graziela DAC, Artur FD, Alexandre F, Thelma S.Application of the Pediatric Risk of Mortality Score (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit. CLINICS. 2010; 65(11): 1087-1092.
- Madaan G, Bhardwaj AK, Sharma PD, Dhanjal GS. Validity of PRISM score in prediction of mortality in North Indian pediatric intensive care unit. Indian J Child Health. 2014;1(3):105-8.
- Bellad Outcome of Intensive Care Unit Patients Using Pediatric Risk of Mortality (PRISM) Score: Indian pediatrics. 2009 Dec;46(12):1091-2
- Thukral A. Performance of Paediatric Risk of Mortality (PRISM), Paediatric Index of Mortality (PIM) and PIM2 in a paediatric intensive care unit in a developing country. Pediatr Crit Care Med 2006 Jul;7(4):356-61.
Corresponding Author
Dr J Bikrant Kumar Prusty
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile no-9437160366
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.12
