title: Pediatric Index of Mortality and PIM2 scores have good calibration in a large cohort of children from a developing country.
abstract: OBJECTIVE
  Our objective was to validate the Pediatric Index of Mortality (PIM) and PIM2 scores in a large cohort of children from a developing country.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Pediatric intensive care unit of a tertiary care teaching hospital.
  
  
  METHODS
  All children aged <18 years admitted between June 2011 and July 2013.
  
  
  RESULTS
  We evaluated the discriminative ability and calibration as measured by the area under the receiver operating characteristic (ROC) curves, the Hosmer-Lemeshow goodness-of-fit (GOF), and standardized mortality ratio (SMR), respectively. Of the 819 children enrolled, 232 (28%) died. The median (IQR) age of the study subjects was 4 years (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis. The area under ROC curves for PIM and PIM2 was 0.72 (95% CI: 0.67-0.75) and 0.74 (95% CI: 0.70-0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores with P values being >0.05. The SMR (95% CI) was 0.99 (0.85-1.15) and 1 (0.85-1.16) for PIM and PIM2, respectively. The calibration across different age and diagnostic subgroups was also good.
  
  
  CONCLUSIONS
  PIM and PIM2 scores had good calibration in our setup.
authors.affiliation: Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India.
authors.forename: Jhuma
authors.identifier: 0000-0002-9807-6550
authors.initials: J
authors.lastname: Sankar
authors.affiliation: Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: M Jeeva
authors.initials: MJ
authors.lastname: Sankar
authors.affiliation: Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Joghee
authors.affiliation: Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India.
authors.forename: Shashikant
authors.initials: S
authors.lastname: Dewangan
authors.affiliation: Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India.
authors.forename: Nandkishore
authors.initials: N
authors.lastname: Dubey
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D018805:Sepsis / Q000401:mortality*; D012720:Severity of Illness Index; D062606:Tertiary Care Centers