Application of pediatric index of mortality version 2: score in pediatric intensive care unit in an African developing country.
BACKGROUND
Outcome of patients admitted to PICU can be evaluated by many illness severity scoring systems. This prospective observational study evaluated the outcome of patients admitted to PICU in Fayoum University hospital of a developing country using the pediatric index of mortality version 2 scoring system.


METHODS
All patients included in this study were subjected to data collection including demographics, diagnoses at admission, duration of ICU stay (DOS), pediatric index of mortality version 2 (PIM2) score and hospital outcome. The ratio of observed to predicted mortality (standardized mortality ratio (SMR)) was calculated for the set of patients.


RESULTS
The study included 205 patients. The main causes of admission were respiratory, cardiovascular and neurological illnesses. Patients stay in ICU ranged from 1 - 45 days with a median 6 (interquartile range (IQ): 3-9) days. Discriminatory function of PIM2 scoring system was acceptable with the area under the ROC curve 0.76 (95%CI: 0.60-0.91). PIM2 calibrated well using Hosmer Lemeshow analysis (H-L X2= 1.410, df= 8, p=0.9). The mean predicted mortality was 5.6 (95% CI: 3.43 - 7.91) and the observed mortality was 8.8% giving a SMR 1.55.


CONCLUSIONS
PIM2 scoring system show adequate discriminatory function and well calibrated for the case mix of patients in PICU of Fayoum, Egypt. It can be used as beneficial tool for evaluation of risk adjusted mortality. Further larger scale studies in cooperation with other Egyptian universities and neighboring countries can improve the performance of our PICUs and critical care services.
Pediatrics Department, Faculty of Medicine, Al Fayoum University, Al Fayoum, Egypt.
Osama El Sayed Mohamed
Oel S
Bekhit
Pediatrics Department, Faculty of Medicine, Al Fayoum University, Al Fayoum, Egypt.
AlKassem Ahmed
AA
Algameel
Pediatrics Department, Faculty of Medicine, Al Fayoum University, Al Fayoum, Egypt.
Hanaa Hasan
HH
Eldash
D000293:Adolescent; D002648:Child; D004534:Egypt; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D011446:Prospective Studies; D012306:Risk
PICU; PIM2; developing country