Pediatric index of mortality 2 score as an outcome predictor in pediatric Intensive Care Unit in India

Abstract

Background and aims: Pediatric index of mortality (PIM) 2 score is one of the severity scoring systems being used for predicting outcome of patients admitted to intensive care units (ICUs). The aim of the present study was to evaluate the usefulness of PIM2 score in predicting mortality in a tertiary care pediatric ICU (PICU) and to assess the associated factors in predicting mortality such as presence of shock, need for assisted ventilation and Glasgow coma scale <8.

Materials and methods: This was a prospective observation study done at tertiary care PICU from May 2011 to July 2011. Consecutive 119 patients admitted to PICU (aged 1 month to 12 years) were enrolled in the study. PIM2 scoring was done for all patients. The outcome was recorded as death or discharge. The associated factors for mortality were analyzed with SPSS 17.

Results: PIM2 score discriminated between death and survival at a 99.8 cut-off, with area under receiver operating characteristic curve 0.843 with 95% confidence interval (CI) (0.765, 0.903). Most patients were referred late to this hospital, which explains higher death rate (46.2%), lesser length of hospital stay (mean 2.98 days) in the mortality group, and increased rate of mechanical ventilation (68.1%). Presence of shock was independently associated with mortality, as evidenced by binary logistic regression.

Conclusion: PIM2 score discriminated well between survivors and death at PICU. Presence of shock was significantly associated with mortality.

Keywords: Mortality; pediatric index of mortality 2 score; shock; ventilation.

Figure 1

Receiver operating characteristic curve. The discrimination of PIM2 score between death and survival was good at 99.8 cut-off, reflected by area under ROC, which was 0.843 (95% CI: 0.765, 0.903)