The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

Journal Title: Paediatrica Indonesiana - Year 2017, Vol 57, Issue 3

Abstract

Background For critically ill patients in the pediatric intensive care unit (PICU), a scoring system is helpful for assessing the severity of morbidity and predicting the risk of mortality. The Pediatric Index of Mortality (PIM) 3 score consists of ten easy simple variables, so that the probability of death can be assessed prior to undergoing advanced therapies. The PIM 3 score in inexpensive and comprised of routine laboratory variables performed in PICU patients. In Indonesia, studies to validate the PIM 3 score have been limited.Objective To evaluate the PIM 3 score for predicting the probability of death in the PICU, Dr. Mohammad Hoesin Hospital (MHH), Palembang.Methods A prospective, cohort study was performed in the PICU, MHH, Palembang, from February to April 2016. The PIM 3 score was calculated within 2 hours of patients admission to the PICU by an  android calculator application. PIM3 score and mortality were analyzed by Mann-Whitney test; calibration was performed by Hosmer-Lameshow goodness of fit test, discrimination was done by receiver operating characteristic (ROC) curve analysis; and standardized mortality ratio (SMR) was calculated.Results During the study period there were 81 PICU patients, 69 children were included, ranging in age from 1,5 to 187 months. The overall mortality rate was 40,58%. The most common illnesses in our subjects were malignancy (17,4%), post non-thoracic surgery (14,5%), dengue shock syndrome (14,5%), respiratory disease (13%), and neurological disease (11,6%). Subjects’ PIM3 scores ranged from 1,02% to 58,84%, with means of 26,08% in non-survivors and 13,05% in survivors. The SMR was 2,24, indicating that death was underpredicted. The AUC of 0,771 (95% CI of 0,651 to 0,891) indicated that the PIM3 score had good discrimination.Conclusion In Mohammad Hoesin Hospital, Palembang, South Sumatera, the PIM 3 can be used to predict mortality in PICU patients, but the score should be multiplied by a factor of 2.24. This recalibration is needed due to the presumed lower standard of care at this hospital compared to that of the originating PIM 3 institutions in developed countries.

Authors and Affiliations

Destiana Sari, Indra Saputra, Silvia Triratna, Mgs. Saleh

Keywords

Related Articles

Association between specific language impairment and behavioral disorders among preschool children

BackgroundSpecific language impairment (SU) is the mostcommon developmental disorder in preschool children, causingserious impairmentE on behavioral development. To date, there havebeen few studies on SU and behavioral d...

Gross motor dysfunction as a risk factor for aspiration pneumonia in children with cerebral palsy

Background Respiratory problems, such as aspiration pneumonia, are major causes of morbidity and mortality in children with cerebral palsy (CP) and greatly affect the quality of life of these children. Nevertheless, ther...

Continuous sedation vs. daily sedation interruption in mechanically-ventilated children

Background A daily sedation interruption (DSI) protocol in ventilated patientsis an effective method of improving sedation management that decreases the duration of mechanical ventilation. In adult patients, it is a safe...

Anemia among children and adolescents in a rural area

Background Anemia in children and adolescents affects growthand development. It is a preventable disease, but unfortunately isoften ignored until the symptoms occur. There have been limitedreports on the prevalence of an...

Probiotic Weisella paramesenteroides on enteropathogenic E. coli-induced diarrhea

BackgroundEnteropathogenic Escherichia coli (EPEC) is a causative agent of intestinal inflammation and microfloral imbalance, leading to diarrhea. The presence of tumor necrosis factor-α (TNF-α) in the feces is an indica...

Download PDF file
  • EP ID EP438219
  • DOI 10.14238/pi57.3.2017.164-70
  • Views 99
  • Downloads 0

How To Cite

Destiana Sari, Indra Saputra, Silvia Triratna, Mgs. Saleh (2017). The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia. Paediatrica Indonesiana, 57(3), 164-70. https://europub.co.uk/articles/-A-438219