The aim is To evaluate the performance of the Pediatric Index of Mortality 3 as mortality risk assessment model. This prospective study included all admissions 30 days to 18 years old for 12 months during 2016 and 2017. Data gathered included the following: age and gender, diagnosis and reason for PICU admission, data specific for the Pediatric Index of Mortality 3 calculation, PICU outcomes (death or survival), and length of PICU stay.
Nine units that care for children within tertiary or quaternary academic hospitals in South Africa. All admissions 30 days to 18 years old, excluding premature infants, children who died within 2 hours of admission, or children transferred to other PICUs, and those older than 18 years old.
There were 3,681 admissions of which 2,253 (61.3%) were male. The standardized mortality ratio for all age groups was greater than. Standardized mortality ratio for diagnostic subgroups was mostly greater than 1 except for those whose reason for PICU admission was classified as an accident, toxin, and envenomation, and metabolic which had a standardized mortality ratio less than 1. There were similar proportions of respiratory patients, but significantly greater proportions of neurologic and cardiac (including postoperative) patients in the Pediatric Index of Mortality 3 derivation cohort than the South African cohort. In contrast, the South African cohort contained a significantly greater proportion of miscellaneous (including injury/accident victims) and postoperative non-cardiac patients. The Pediatric Index of Mortality 3 discrimination between death and survival among South African units was good. Case-mix differences between these units and the Pediatric Index of Mortality 3 derivation cohort may partly explain the poor calibration. We need to recalibrate the Pediatric Index of Mortality 3 to the local setting.
Reference link:
https://journals.lww.com/pccmjournal/fulltext/2021/09000/pediatric_index_of_mortality_3_an_evaluation_of.7.aspx
