title: Risk adjusted mortality of critical illness in a defined geographical region.
abstract: OBJECTIVE
  To evaluate the performance of the Paediatric Risk of Mortality (PRISM) score in a population of UK children and to use this score to examine severity of illness adjusted mortality of critically ill children <16 years old in a defined geographical region.
  
  
  METHODS
  Observational study of a defined population of critically ill children (<16 years old) admitted to hospitals in the South West Region between 1 December 1996 and 30 November 1998.
  
  
  RESULTS
  Data were collected from 1148 eligible admissions. PRISM was found to perform acceptably in this population. There was no significant difference between the overall number of observed deaths and those predicted by PRISM. Admissions with mortality risk 30% or greater had significantly greater odds ratio for death in general intensive care units compared with the tertiary paediatric intensive care unit.
  
  
  CONCLUSIONS
  Children with a high initial risk of mortality based on PRISM score were significantly more likely to survive in a tertiary paediatric intensive care unit than in general intensive care units in this region. However, there was no evidence from this study that admissions with lower mortality risk than 30% had significantly worse mortality in non-tertiary general units than in tertiary paediatric intensive care units.
authors.affiliation: Institute of Child Health, Bristol Royal Hospital for Children, Bristol, UK. a.j.henderson@bris.ac.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Henderson
authors.forename: L
authors.initials: L
authors.lastname: Garland
authors.forename: S
authors.initials: S
authors.lastname: Warne
authors.forename: L
authors.initials: L
authors.lastname: Bailey
authors.forename: P
authors.initials: P
authors.lastname: Weir
authors.forename: S
authors.initials: S
authors.lastname: Edees
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D016638:Critical Illness / Q000401:mortality*; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index