PRISM III score as a mortality predictor in a pediatric intensive care unit of a tertiary care hospital

Abstract

Objectives: To evaluate the sensitivity of the PRISM III score in patients admitted to PICU and to find a cut off PRISM III score. Method: Four hundred children admitted to the PICU of a tertiary care hospital over a period of 18 months were enrolled in this cross-sectional observational study. PRISM III score was calculated using variables after admission in first 24 hours. The outcome was defined as survivors and deceased. Results: Out of 400 patients, 70 died and 330 survived. The male to female ratio was 219:181 (55%:45%). Majority of patients were below or equal to 12 months of age (50%). The mean age was 32.9 months for non survivors, while 37.5 months for survivors. Gender, age, residence of the patient had no association with the outcome. Referred, incompletely immunized and children requiring ventilation within 1 hour of admission had poor outcome. Average PRISM III score was higher in non survivors (14.6) as compared to survivors (4.1). The mortality was significantly higher with high PRSIM III score. The area under the receiver operating characteristics curve was 0.96. The cut-off PRISM III score was 9 (kappa coefficient 0.747). Conclusion: PRISM III score can be applied with a good degree of accuracy for severity assessment and mortality prediction to pediatric patients in PICU.

Keywords

• picu
• mortality
• prism iii score
• outcome