title: Performance of PRISM III and PELOD-2 scores in a pediatric intensive care unit.
abstract: The study aims were to compare two models (The Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD-2)) for prediction of mortality in a pediatric intensive care unit (PICU) and recalibrate PELOD-2 in a Portuguese population. To achieve the previous goal, a prospective cohort study to evaluate score performance (standardized mortality ratio, discrimination, and calibration) for both models was performed. A total of 556 patients consecutively admitted to our PICU between January 2011 and December 2012 were included in the analysis. The median age was 65 months, with an interquartile range of 1 month to 17 years. The male-to-female ratio was 1.5. The median length of PICU stay was 3 days. The overall predicted number of deaths using PRISM III score was 30.8 patients whereas that by PELOD-2 was 22.1 patients. The observed mortality was 29 patients. The area under the receiver operating characteristics curve for the two models was 0.92 and 0.94, respectively. The Hosmer and Lemeshow goodness-of-fit test showed a good calibration only for PRISM III (PRISM III: χ (2) = 3.820, p = 0.282; PELOD-2: χ (2) = 9.576, p = 0.022).
  
  
  CONCLUSIONS
  Both scores had good discrimination. PELOD-2 needs recalibration to be a better reliable prediction tool.
  
  
  BACKGROUND
  • PRISM III (Pediatric Risk of Mortality III) and PELOD (Pediatric Logistic Organ Dysfunction) scores are frequently used to assess the performance of intensive care units and also for mortality prediction in the pediatric population. • Pediatric Logistic Organ Dysfunction 2 is the newer version of PELOD and has recently been validated with good discrimination and calibration. What is New: • In our population, both scores had good discrimination. • PELOD-2 needs recalibration to be a better reliable prediction tool.
authors: Pediatric Intensive Care Unit, Pediatric Integrated Hospital, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. pierre_3.14r@hotmail.com.|Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga and ICVS-3Bs, PT Government Associate Laboratory, Braga, Guimarães, Portugal. pierre_3.14r@hotmail.com.
authors: Jean-Pierre
authors: JP
authors: Gonçalves
authors: Institute of Public Health, University of Porto, Porto, Portugal. milton@med.up.pt.|Department of Clinical Epidemiology, Predictive Medicine and Public Health and Cardiovascular Research & Development Unit, University of Porto Medical School, Porto, Portugal. milton@med.up.pt.
authors: Milton
authors: M
authors: Severo
authors: Pediatric Intensive Care Unit, Pediatric Integrated Hospital, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. carlamrocha@sapo.pt.
authors: Carla
authors: C
authors: Rocha
authors: Pediatric Intensive Care Unit, Pediatric Integrated Hospital, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. joanajardim@sapo.pt.
authors: Joana
authors: J
authors: Jardim
authors: Pediatric Intensive Care Unit, Pediatric Integrated Hospital, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. teresaraquelsousa@gmail.com.
authors: Teresa
authors: T
authors: Mota
authors: Pediatric Intensive Care Unit, Pediatric Integrated Hospital, São João Hospital, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal. augusto.ribeiro@hsjoao.min-saude.pt.
authors: Augusto
authors: A
authors: Ribeiro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D015233:Models, Statistical; D011174:Portugal / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D015996:Survival Rate / Q000639:trends
keywords: Cohort study; Mortality; Prediction; Prognostic score