Prognostic scoring systems in pediatric ICUs: Pediatric Risk of Mortality III versus Pediatric Index of Mortality 2

Background Estimations of disease severity and probability of death are important elements in determining the prognosis of patients in pediatric ICU (PICU), and a more accurate prognostic assessment can lead to more appropriate monitoring, proper management, and family counseling. Objective The aim of the study was to compare the performance of the PRISM III (Pediatric Risk of Mortality III) and the PIM2 (Pediatric Index of Mortality 2) scores at PICU and to investigate the relation between scores and mortality. Patients and methods A prospective observational cohort study was conducted at PICU, Menoufia University Hospital, Egypt, during the period of February to October 2017. The study was approved by the Ethical Committee of Menoufia University Hospital. A total of 50 patients were included during the study period. Within the first hour of admission, PIM2 and PRISM III scores were applied. Patients were followed up for outcome, measured in the form of survivors and nonsurvivors. Results A total 50 patients were included, of whom 35 were survivors and 15 were nonsurvivors. Most survivors and nonsurvivors were females, but there was no statistical significant influence on outcome. The area under the receiver operating characteristic curve was 0.937 (0.863–1.000) for PRISM III and 0.870 (0.759–0.99) for PIM2. There was a positive correlation between the two scores on the day of admission. Conclusion Both PRISM III and PIM2 scores have a good discriminatory performance. PRISM III has better discrimination ability on admission in comparison with PIM2.