Outcome of Patients Admitted To PICU and NICU In Relation To PRISM III Score in a Tertiary Care Hospital

Outcome of Patients Admitted To PICU and NICU

  • Khaleelullah MD Shakil Assistant Professor, Department of Pediatrics, Basaveshwara Medical College Hospital and Research Centre, Chitradurga, Karnataka, India
  • Pavan D. Kumar Associate Professor, Department of Pediatrics, DM Wayanad Institute of Medical Sciences, Meppadi, Wayanad, Kerala, India https://orcid.org/0000-0002-3608-9153
  • Sreenivasa B. Professor, Department of Pediatrics, Basaveshwara Medical College Hospital and Research Centre, Chitradurga, Karnataka, India
  • Talatam Sivachand Senior Resident, Department of Pediatrics, Basaveshwara Medical College Hospital and Research Centre, Chitradurga, Karnataka, India
Keywords: PRISM III scores, PICU, NICU, Mortality rate

Abstract

Introduction: Pediatric intensive care units (PICU) are an indispensable component of a successful health care establishment. They play a crucial part in reducing morbidity and mortality in the adolescent group. Several models and scores have been tried for internal auditing and in detecting the case fatality rate of a patient admitted in PICU and NICU. This helps the clinician in triaging patient care as and when required. The PRISM III score is widely used in PICU and NICU for the same. To evaluate the validity of the PRISM III score in predicting mortality in children admitted to PICU and NICU in a tertiary care hospital and to predict the probability of death of various PRISM III scores. Subjects and Methods: 260 patients admitted to PICU and NICU were included in the study after obtaining informed consent from parents/guardians. Each patient was evaluated for the parameters in the PRISM III score and blood was drawn to send for investigations and results were entered in the proforma and were evaluated. Results: There was an increase in mortality rate with raise in PRISM III score. PRISM III offered a fair predictive power with the area under the curve 0.7 with 95% C.I. Out of 260 patients included in the study 24(9.2%) were dead. Variables like systolic BP, abnormal mental status, pupillary reflex, acidosis, and low platelet counts were significantly associated with a higher mortality rate. Conclusion: Evaluation of mortality and outcome of a patient admitted in PICU in a tertiary care hospital is best predicted by PRISM III score.

Downloads

Download data is not yet available.

References

Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, et al. State of newborn health in India. J Perinatol. 2016;36(Suppl 3):S3–S8. Available from: https://dx.doi.org/10.1038/jp.2016.183.

Carter BS, Howenstein M, Gilmer MJ, Throop P, France D, Whitlock JA. Circumstances surrounding the deaths of hospitalized children: opportunities for pediatric palliative care. Pediatrics. 2004;114(3):361–367. Available from: https://doi.org/10.1542/peds.2003-0654-f.

Fiser D. Textbook of Pediatric Intensive Care. Rogers M, G ND, editors; 1996.

Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score; 1988. Available from: https://dx.doi.org/10.1097/00003246-198811000-00006.

Shann F, Pearson G, Slater A, Wilkinson K. Paediatric index of mortality (PIM): a mortality prediction model for children in intensive care; 1997. Available from: https://dx.doi.org/10.1007/s001340050317.

Varma A, Damke S, Meshram R, Vagha J, Kher A, Vagha K. Prediction of mortality by pediatric risk of mortality (PRISM III) score in teriary care rural hospital in India. Int J Contemp Pediatr. 2017;4(2):322–322. Available from: https://dx.doi.org/10.18203/2349-3291.ijcp20170003.

Bhatia RC, Singh D, Gautam A, Pooni PA, Shimar TS. NCPCC 2005 - Conference Abstracts. 2006;5:3–3.

Gemke RJ, van Vught JA. Scoring systems in pediatric intensive care: PRISM III versus PIM. Intensive Care Med. 2002;28(2):204–207. Available from: https://dx.doi.org/10.1007/s00134-001-1185-2.

Pollack MM, Patel KM, Ruttimann UE. PRISM III; 1996. Available from: https://dx.doi.org/10.1097/00003246199605000-00004.

Fargason CA, Langman CB. Limitations of the pediatric risk of mortality score in assessing children with acute renal failure; 1993. Available from: https://dx.doi.org/10.1007/bf01213327.

Ponce AL. Simplified PRISM III score and outcome in the pediatric intensive care unit. Pediatr Int. 2005;47(1):80– 83. Available from: https://doi.org/10.1111/j.1442-200x.2004.01997.x.

Tan GH, Tan TH, Goh DY, Yap HK. Risk factors for predicting mortality in a pediatric intensive care unit. Ann Acad Med. 1998;27(6):813–821.

Khilnani P, Sarma D, Singh R, Uttam R, Rajdev S, Makkar A, et al. Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Indian J Pediatr. 2004;71(7):587–591. Available from: https://dx.doi.org/10.1007/bf02724117.

Choi KM, Ng DK, Wong SF, Kwok KL, Chow PY, Chan CH, et al. Assessment of the Pediatric Index of Mortality (PIM) and the Pediatric Risk of Mortality (PRISM) III score for prediction of mortality in a pediatric intensive care unit in Hong Kong. Hong Kong Med J. 2005;11(2):97–103.

Bilan N, Galehgolab BA, Emadaddin A, Shiva S. Risk of Mortality in Pediatric Intensive Care Unit, Assessed by PRISM-III. Pak J Biol Sci. 2009;12(6):480–485. Available from: https://dx.doi.org/10.3923/pjbs.2009.480.485.

Brady AR, Harrison D, Black S, Jones S, Rowan K, Pearson G, et al. Assessment and optimization of mortality prediction tools for admissions to pediatric intensive care in the United Kingdom. Pediatrics. 2006;117(4):733–775. Available from: https://doi.org/10.1542/peds.2005-1853.

Slater A, Shann F. The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatr Crit Care Med. 2004;5(5):447–454. Available from: https://dx.doi.org/10.1097/01.pcc.0000138557.31831.65.

Published
2020-12-28
How to Cite
Khaleelullah MD Shakil, Pavan D. Kumar, Sreenivasa B., & Talatam Sivachand. (2020). Outcome of Patients Admitted To PICU and NICU In Relation To PRISM III Score in a Tertiary Care Hospital. Asian Journal of Clinical Pediatrics and Neonatology, 8(4), 13-18. https://doi.org/10.47009/ajcpn.2020.8.4.4
Section
Original Article