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首页> 外文期刊>Southern African Journal of Critical Care >Paediatric Index of Mortality scores: An evaluation of function in the paediatric intensive care unit of the Red Cross War Memorial Children's Hospital
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Paediatric Index of Mortality scores: An evaluation of function in the paediatric intensive care unit of the Red Cross War Memorial Children's Hospital

机译：儿科死亡率指数评分：红十字会战争纪念儿童医院儿科重症监护室功能评估

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BACKGROUND: Paediatric Index of Mortality (PIM) and PIM 2 scores have been shown to be valid predictors of outcome among paediatric intensive care unit populations in the UK, New Zealand, Australia and Europe, but have never been evaluated in the South African context. OBJECTIVE: To evaluate the PIM and PIM 2 as mortality risk assessment models. Method. A retrospective audit of case records and prospectively collected patient data from all admissions to the Paediatric Intensive Care Unit (PICU) of Red Cross War Memorial Children's Hospital, Cape Town, during the years 2000 (PIM) and 2006 (PIM 2), excluding premature infants, children who died within 2 hours of admission, or children transferred to other PICUs. RESULTS: For PIM and PIM 2 there were 128/962 (13.3%) and 123/1113 (11.05%) PICU deaths with expected mean mortality rates of 12.14% and 12.39%, yielding standardised mortality risk ratios (SMRs) of 1.1 (95% confidence interval (CI) 0.93 - 1.34) and 0.9 (95% CI 0.74 - 1.06), respectively. Receiver operating characteristic analysis revealed area under the curve of 0.849 (PIM) and 0.841 (PIM 2). Hosmer-Lemeshow goodness of fit revealed poor calibration for PIM (χ2=19.74; p=0.02) and acceptable calibration for PIM 2 (χ2=10.06; p=0.35). SMR for age and diagnostic subgroups for both scores fell within wide confidence intervals. CONCLUSION: Both scores showed good overall discrimination. PIM showed poor calibration. For PIM 2 both discrimination and calibration were comparable to the score derivation units, at the time of data collection for each. Calibration in terms of age and diagnostic categories was not validated by this study.
机译：背景：在英国，新西兰，澳大利亚和欧洲，小儿重症监护病房（PIM）和PIM 2评分已被证明是小儿重症监护病房结局的有效预测指标，但从未在南非进行评估。目的：评估PIM和PIM 2作为死亡风险评估模型。方法。对2000年（PIM）和2006年（PIM 2）期间开普敦红十字战争纪念儿童医院小儿重症监护病房（PICU）的所有入院病例记录和前瞻性收集的患者数据进行回顾性审核，但不包括早产儿婴儿，入院后两小时内死亡的儿童，或转移到其他PICU的儿童。结果：对于PIM和PIM 2，PICU死亡分别为128/962（13.3％）和123/1113（11.05％），预期平均死亡率分别为12.14％和12.39％，标准死亡率为1.1（95）。 ％置信区间（CI）为0.93-1.34）和0.9（95％CI为0.74-1.06）。接收器工作特性分析显示曲线下面积为0.849（PIM）和0.841（PIM 2）。 Hosmer-Lemeshow拟合优度表明，对PIM的校准较差（χ2= 19.74; p = 0.02），对PIM 2的校准尚可接受（χ2= 10.06; p = 0.35）。这两个分数的年龄和诊断亚组的SMR均处于较宽的置信区间内。结论：两个分数均显示出良好的总体歧视。 PIM校准不良。对于PIM 2，在每个数据收集时，判别和校准均与得分推导单位相当。年龄和诊断类别方面的校准未经本研究验证。

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