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Comparative Study
. 2010 Apr 26:36:35.
doi: 10.1186/1824-7288-36-35.

Validation of "Signs of Inflammation in Children that Kill" (SICK) score for immediate non-invasive assessment of severity of illness

Manoj A Gupta  1 , Anjan Chakrabarty, Ruth Halstead, Mohit Sahni, Jayanti Rangasami, Ashish Puliyel, Vishnubhatla Sreenivas, David A Green, Jacob M Puliyel
Affiliations
Comparative Study

Validation of "Signs of Inflammation in Children that Kill" (SICK) score for immediate non-invasive assessment of severity of illness

Manoj A Gupta et al. Ital J Pediatr. .

Abstract

Objective: To validate the SICK scoring system's ability to differentiate between individuals with higher and lower probabilities of death

Method: We performed a one year two-centre prospective evaluation of all children aged between one month and 12 years referred to the Paediatric team at St Stephens Hospital in Delhi and admitted to the Paediatric Department at West Middlesex University Hospital in London. We calculated SICK scores at presentation and correlated them with subsequent in-hospital mortality. We used discrimination by areas under receiver operating characteristic (ROC) curves to measure performance.

Results: We prospectively evaluated 3895 children in Delhi and 1473 children in London. The areas under the ROC curves were 84.8% in Delhi, 81.0% in London and 84.1% (95% CI 77.4-90.8%) for combined data. Hosmer-Lemeshow goodness of fit for the combined data was good (Hosmer-Lemeshow Chi-square=2.13 (p=0.345).

Conclusions: We propose the SICK score as a useful triage tool at initial presentation and highlight its particular suitability for resource poor settings.

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Figures

Figure 1
Figure 1
Areas under ROC curves.
Figure 2
Figure 2
Observed and Expected number of deaths per 1000 in each score category.
See this image and copyright information in PMC

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