title: [Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit].
abstract: OBJECTIVE
  To compare the performance of the PRISM (Pediatric Risk of Mortality) and the PIM (Pediatric Index of Mortality) scores at a general pediatric intensive care unit, investigating the relation between observed mortality and survival and predicted mortality and survival.
  
  
  METHODS
  A contemporary cohort study undertaken between 1 June 1999 and 31 May 2000 at the Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas pediatric intensive care unit. The inclusion criteria and the PRISM and PIM calculations were performed as set out in the original articles and using the formulae as published. Statistical analysis for model evaluation employed the Flora z test, Hosmer-Lemeshow goodness-of-fit test, ROC curve (receiver operating characteristic) and Spearman's correlation tests. The study was approved by the institution's Ethics Committee.
  
  
  RESULTS
  Four hundred and ninety-eight patients were admitted to the pediatric intensive care unit, 77 of whom presented exclusion criteria. Thirty-three (7.83%) of the 421 patients studied died and 388 patients were discharged. Estimated mortality by PRISM was 30.84 (7.22%) with a standardized mortality rate of 1.07 (0.74-1.50), z = -0.45 and by PIM this was 26.13 (6.21%) with a standardized mortality rate of 1.26 (0.87-1.77), z = -1.14. The Hosmer-Lemeshow test gave a chi-square of 9.23 (p = 0.100) for PRISM and 27.986 (p < 0.001) for PIM. The area under the ROC curve was 0.870 (0.810-0.930) for PRISM and 0.845 (0.769-0.920) for PIM. The Spearman test returned r = 0.65 (p < 0.001).
  
  
  CONCLUSIONS
  Analyzing the tests we can observe that, although the PIM test was less well calibrated overall, both PRISM and PIM offer a good capacity for discriminating between survivors and moribund patients. They are tools with comparable performance at the prognostic evaluation of the pediatric patients admitted to our unit.
authors.affiliation: Unidade de Terapia Intensiva Pediátrica, Hospital Moinhos de Vento, Porto Alegre, RS.
authors.forename: Vanessa Feller
authors.initials: VF
authors.lastname: Martha
authors.forename: Pedro Celiny Ramos
authors.initials: PC
authors.lastname: Garcia
authors.forename: Jefferson Pedro
authors.initials: JP
authors.lastname: Piva
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Einloft
authors.forename: Francisco
authors.initials: F
authors.lastname: Bruno
authors.forename: Viviane
authors.initials: V
authors.lastname: Rampon
mesh_terms: D002648:Child; D015331:Cohort Studies; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D011336:Probability; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index