TY - JOUR
T1 - The importance of mortality risk assessment: Validation of the pediatric index of mortality 3 score
AU - Wolfler, Andrea
AU - Osello, Raffaella
AU - Gualino, Jenny
AU - Calderini, Edoardo
AU - Vigna, Gianluca
AU - Santuz, Pierantonio
AU - Amigoni, Angela
AU - Savron, Fabio
AU - Caramelli, Fabio
AU - Rossetti, Emanuele
AU - Cecchetti, Corrado
AU - Corbari, Maurizio
AU - Piastra, Marco
AU - Testa, Raffaele
AU - Coffaro, Giancarlo
AU - Stancanelli, Giusi
AU - Gitto, Eloisa
AU - Amato, Roberta
AU - Prinelli, Federica
AU - Salvo, Ida
AU - Racca, F.
AU - Ferrero, F.
AU - Zoia, E.
AU - Mandelli, A.
AU - Montani, C.
AU - Prandi, E.
AU - Molinaro, S.
AU - Biban, P.
AU - Pettenazzo, A.
AU - Furlan, S.
AU - Mondardini, C.
AU - Iannella, E.
AU - Perrotta, D.
AU - Picardo, S.
AU - Conti, Giorgio
AU - Genovese, O.
AU - Dolcini, A.
AU - D Amato, L.
AU - Guddo, A. M.
AU - Giglio, A. M.
PY - 2016
Y1 - 2016
N2 - Objective: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU. Design: Retrospective, prospective cohort study. Setting: Seventeen Italian PICUs. Patients: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014. Interventions: None. Measurement and Main Results: Eleven thousand one hundred nine children were enrolled in the study. The mean Pediatric Index of Mortality 2 and 3 values of 4.9 and 3.9, respectively, differed significantly (p 0.05). Overall mortality rate was 3.9%, and the standardized mortality ratio was 0.80 for Pediatric Index of Mortality 2 and 0.98 for Pediatric Index of Mortality 3 (p 0.05). The area under the curve of the receiver operating characteristic curves was similar for Pediatric Index of Mortality 2 and Pediatric Index of Mortality 3. The Hosmer-Lemeshow test was not significant for Pediatric Index of Mortality 3 (p = 0.21) but was highly significant for Pediatric Index of Mortality 2 (p 0.001), which overestimated death mainly in high-risk categories. Conclusions: Mortality indices require validation in each country where it is used. The new Pediatric Index of Mortality 3 score performed well in an Italian population. Both calibration and discrimination were appropriate, and the score more accurately predicted the mortality risk than Pediatric Index of Mortality 2.
AB - Objective: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU. Design: Retrospective, prospective cohort study. Setting: Seventeen Italian PICUs. Patients: All children 0 to 15 years old admitted in PICU from January 2010 to October 2014. Interventions: None. Measurement and Main Results: Eleven thousand one hundred nine children were enrolled in the study. The mean Pediatric Index of Mortality 2 and 3 values of 4.9 and 3.9, respectively, differed significantly (p 0.05). Overall mortality rate was 3.9%, and the standardized mortality ratio was 0.80 for Pediatric Index of Mortality 2 and 0.98 for Pediatric Index of Mortality 3 (p 0.05). The area under the curve of the receiver operating characteristic curves was similar for Pediatric Index of Mortality 2 and Pediatric Index of Mortality 3. The Hosmer-Lemeshow test was not significant for Pediatric Index of Mortality 3 (p = 0.21) but was highly significant for Pediatric Index of Mortality 2 (p 0.001), which overestimated death mainly in high-risk categories. Conclusions: Mortality indices require validation in each country where it is used. The new Pediatric Index of Mortality 3 score performed well in an Italian population. Both calibration and discrimination were appropriate, and the score more accurately predicted the mortality risk than Pediatric Index of Mortality 2.
KW - Children
KW - Critical Care and Intensive Care Medicine
KW - Outcome/quality measure
KW - Pediatric intensive care unit
KW - Pediatrics
KW - Perinatology and Child Health
KW - Risk of mortality
KW - Standardized mortality ratio
KW - Validation studies
KW - Children
KW - Critical Care and Intensive Care Medicine
KW - Outcome/quality measure
KW - Pediatric intensive care unit
KW - Pediatrics
KW - Perinatology and Child Health
KW - Risk of mortality
KW - Standardized mortality ratio
KW - Validation studies
UR - https://publicatt.unicatt.it/handle/10807/172335
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84961203235&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84961203235&origin=inward
U2 - 10.1097/PCC.0000000000000657
DO - 10.1097/PCC.0000000000000657
M3 - Article
SN - 1529-7535
VL - 17
SP - 251
EP - 256
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 3
ER -