مجله دانشکده پزشکی اصفهان (May 2010)
Prediction of Pediatric Mortality in Bahrami Children's Hospital Pediatric Intensive Care Unit (PICU) based on Pediatric Index of Mortality-2 (PIM2)
Abstract
Background: This study assessed to study Pediatric Index of Mortality-2 (PIM2) measure for outcome assess-ment of children admitted to pediatric intensive care unit (PICU) of Bahrami children’s hospital. Methods: A prospective cohort study was implemented in Bahrami Children’s Hospital affiliated to Tehran University of Medical Sciences. We studied consecutively all of the patients admitted in PICU from May 2007 through November 2008. Patients’ data were registered at the admission time in related to records. We calculated PIM2 measure and compared expected mortality risk with observed mortality by using logistic regression, ROC curve analysis and standardized mortality ratio. We analyzed goodness of fit of PIM2 index with Hosmer and Lemeshow test. Findings: Two hundred and forty patients were studied. Mean (standard deviation) of age was 31.427 (42.7978). one hundred and fifty (62.5%) were male and 90 (37.5%) were female. The model fitted the test data well (P = 0.741) and area under the receiver operating characteristic plot was 0.795 (0.715-0.875 for 95% C.I.) and standardized mortality ratio was 1.8 (1.28- 2.465 for 95% C.I.). Conclusion: Measurement of bilirubin with transcutaneous bilirubinometry from covered area of glabella in preterm infants undergoing phototherapy could be a useful predictor of serum bilirubin level. With this method, we could reduce blood sampling in preterm neonates. So, the need for blood transfusion, the pain from taking blood and its side effects will be reduced. Keywords: Intensive care unit, Mortality prediction, Outcome assessment, Severity of illness.