title: Comparison of the pediatric risk of mortality, pediatric index of mortality, and pediatric index of mortality 2 models in a pediatric intensive care unit in China: A validation study.
abstract: This study was designed with the aim of comparing the performances of the pediatric risk of mortality (PRISM), pediatric index of mortality (PIM), and revised version pediatric index of mortality 2 (PIM2) models in a pediatric intensive care unit (PICU) in China.A total of 852 critically ill pediatric patients were recruited in the study between January 1 and December 31, 2014. The variables required to calculate PRISM, PIM, and PIM2 were collected. Mode l performance was evaluated by assessing the calibration and discrimination. Discrimination between death and survival was assessed by calculating the area under the receiver-operating characteristic curve (AUC). Calibration across deciles of risk was evaluated using the Hosmer-Lemeshow goodness-of-fit χ test.Of the 852 patients enrolled in this study, 745 patients survived until the end of the PICU stay (107 patients died, 12.56%). The AUCs (95% confidence intervals, CI) were 0.729 (0.670-0.788) for PRISM, 0.721 (0.667-0.776) for PIM, and 0.726 (0.671-0.781) for PIM2. The Hosmer-Lemeshow test revealed a chi-square of 7.26 (P = 0.51, v = 10) for PRISM, 26.28 (P = 0.0009, v = 10) for PIM, and 10.28 (P = 0.21, v = 10) for PIM2. The standardized mortality rate was 1.14 (95%CI: 0.93-1.36) for PRISM, 1.89 (95%CI: 1.55-2.27) for PIM, and 2.13 (95%CI: 1.75-2.55) for PIM2.The PRISM, PIM, and PIM2 scores demonstrated an acceptable discriminatory performance. With the exception of PIM, the PRISM and PIM2 models had good calibrations.
authors.affiliation: Department of Children's Intensive Research Center, Hunan Children's Hospital, Changsha, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qiu
authors.forename: Xiulan
authors.initials: X
authors.lastname: Lu
authors.forename: Kewei
authors.initials: K
authors.lastname: Wang
authors.forename: Yimin
authors.initials: Y
authors.lastname: Zhu
authors.forename: Chao
authors.initials: C
authors.lastname: Zuo
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Xiao
mesh_terms: D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D008962:Models, Theoretical