Comparison of the predictive ability of the pediatric risk of mortality III, pediatric index of Mortality3, and pediatric logistic organ dysfunction-2 in medical and surgical intensive care units

Abstract

Background: The pediatric risk of mortality (PRISM III), pediatric index of mortality (PIM3), and pediatric logistic organ dysfunction (PELOD-2) are of the most used predictive models in predicting the risk of mortality in the pediatric intensive care unit (PICU). Objectives: The current study aimed at comparing the predictive ability of these three modes in medical/surgical ICUs (MICU/SICU). Methods: A total of 90 consecutive patients, aged ≤18 years, admitted to MICUs or SICUs were enrolled in the current observational, prospective study. The PRISM III, PIM3, and PELOD-2 as well as demographic characteristics of the subjects were recorded on admission. A receive operator characteristic (ROC) curve, logistic regression, and the Hosmer-Lemeshow goodness-of-fit test were used for statistical analyses [95% confidence interval (CI)]. Results: Data analysis showed a significant difference in PRISM III, PIM3, and PELOD-2 scores between survivors and nonsurvivors (P < 0.001, P < 0.001, P < 0.001, respectively). The discrimination power was moderate for PRISM III (area under ROC curve (AUC): 77.3%; standard error (SE): 6.0%), and good for PIM3 and PELOD-2 (AUC: 82.4%, SE: 5.5% and AUC: 80.3%, SE: 4.9%, respectively). All the three models were well calibrated (χ2 = 4.73, P = 0.79; χ2 = 3.09, P = 0.93; and χ2 = 5.01, P = 0.66, respectively). Conclusions: PRISM III, PIM3, and PELOD-2 had good performance in predicting outcomes in children admitted to MICUs or SICUs. Further studies on different ICUs may provide more conclusive results with greater generalization of the validity of these predictive models.