Evaluation of the Performance of PRISM III and PIM II Scores in a Tertiary Pediatric Intensive Care Unit

Introduction: The most commonly used scoring systems for the assessment of predicted mortality (PDR) in the pediatric intensive care unit are the "pediatric risk of mortality" (PRISM) and the "pediatric index of mortality" (PIM) scores. The aim of this study is to evaluate the calibration and discrimination of PRISM III and PIM II scores in predicting mortality in a tertiary university hospital pediatric intensive care unit in Turkey.Methods: Demographic data of patients hospitalized in the pediatric intensive care unit between January 1, 2015 and December 31, 2018 were scanned form the electronic records. PRISM III and PIM II score, PDR, and standardized mortality rate (SMR) were calculated. In order to show the discrimination of the scores, the area under the ROC curve (AUC) was calculated and the significance limit was accepted as 0.80. Hosmer-Lemeshow Goodness-of-fit test was used to evaluate the calibrations and p>0.05 was considered significant. Results: After exclusions 825 patients included in the study. The mean value of the PRISM III was 9.5 +/- 6.8 and the mean value of the PIM II score was 1.9 +/- 8.2. The calculated SMR was 1.03 according to the PRISM III score and 0.76 according to the PIM II score. In the ROC analysis performed to evaluate the discrimination, the AUC values for PRISM III PDR and PIM II PDR were; 0.908 +/- 0.017 (p<0.001), 0.855 +/- 0.024 (p<0.001), respectively. When PRISM III and PIM II PDR values were analyzed in groups, the difference between predicted and observed mortality was not statistically significant (p=0>0.05).Conclusion: In this study, it has been shown that the discrimination and calibration of the PRISM III and PIM II score is good in predicting mortality in a tertiary pediatric intensive care unit where medical and surgical patients are accepted.