Background The aim of this study was to evaluate the performance of the four scoring tools in predicting mortality in pediatric intensive care units(PICUs)in western China.Methods This was a multicenter,prospective,co...Background The aim of this study was to evaluate the performance of the four scoring tools in predicting mortality in pediatric intensive care units(PICUs)in western China.Methods This was a multicenter,prospective,cohort study conducted in six PICUs in western China.The performances of the scoring systems were evaluated based on both discrimination and calibration.Discrimination was assessed by calculating the area under the receiver operating characteristic curve(AUC)for each model.Calibration was measured across defined groups based on mortality risk using the Hosmer-Lemeshow goodness-of-fit test.Results A total of 2034 patients were included in this study,of whom 127(6.2%)died.For the entire cohort,AUCs for Pediatric Risk of Mortality Score(PRISM)I,Pediatric Index of Mortality 2(PIM2),Pediatric Logistic Organ Dysfunction Score-2(PELOD-2)and PRISM IV were 0.88[95%confidence interval(CI)0.85–0.92],0.84(95%CI 0.80–0.88),0.80(95%CI 0.75–0.85),and 0.91(95%CI 0.88–0.94),respectively.The Hosmer-Lemeshow goodness-of-fit Chi-square value was 12.71(P=0.12)for PRISM I,4.70(P=0.79)for PIM2,205.98(P<0.001)for PELOD-2,and 7.50(P=0.48)for PRISM IV[degree of freedom(df)=8].The standardized mortality ratios obtained with the PRISM I,PIM2,PELOD-2,and PRISM IV models were 0.87(95%CI,0.75–1.01),0.97(95%CI,0.85–1.12),1.74(95%CI,1.58–1.92),and 1.05(95%CI,0.92–1.21),respectively.Conclusions PRISM IV performed best and can be used as a prediction tool in PICUs in Western China.However,PRISM IV needs to be further validated in NICUs.展开更多
基金supported by the National Natural Science Foundation of China(Grant Numbers 81400862 and 81401606)the Key Project of the Science&Technology Program of Sichuan Province(Grant Number 2019YFS0322)+1 种基金the Science Foundation for The Excellent Youth Scholars of Sichuan University(grant number 2015SU04A15)the 1·3·5 Project for Disciplines of Excellence,West China Hospital of Sichuan University(Grant Numbers 2019HXFH056,2020HXFH048 and YJC21060).
文摘Background The aim of this study was to evaluate the performance of the four scoring tools in predicting mortality in pediatric intensive care units(PICUs)in western China.Methods This was a multicenter,prospective,cohort study conducted in six PICUs in western China.The performances of the scoring systems were evaluated based on both discrimination and calibration.Discrimination was assessed by calculating the area under the receiver operating characteristic curve(AUC)for each model.Calibration was measured across defined groups based on mortality risk using the Hosmer-Lemeshow goodness-of-fit test.Results A total of 2034 patients were included in this study,of whom 127(6.2%)died.For the entire cohort,AUCs for Pediatric Risk of Mortality Score(PRISM)I,Pediatric Index of Mortality 2(PIM2),Pediatric Logistic Organ Dysfunction Score-2(PELOD-2)and PRISM IV were 0.88[95%confidence interval(CI)0.85–0.92],0.84(95%CI 0.80–0.88),0.80(95%CI 0.75–0.85),and 0.91(95%CI 0.88–0.94),respectively.The Hosmer-Lemeshow goodness-of-fit Chi-square value was 12.71(P=0.12)for PRISM I,4.70(P=0.79)for PIM2,205.98(P<0.001)for PELOD-2,and 7.50(P=0.48)for PRISM IV[degree of freedom(df)=8].The standardized mortality ratios obtained with the PRISM I,PIM2,PELOD-2,and PRISM IV models were 0.87(95%CI,0.75–1.01),0.97(95%CI,0.85–1.12),1.74(95%CI,1.58–1.92),and 1.05(95%CI,0.92–1.21),respectively.Conclusions PRISM IV performed best and can be used as a prediction tool in PICUs in Western China.However,PRISM IV needs to be further validated in NICUs.
