TY - JOUR
T1 - The Importance of Mortality Risk Assessment
T2 - Validation of the Pediatric Index of Mortality 3 Score
AU - Wolfler, Andrea
AU - Osello, Raffaella
AU - Gualino, Jenny
AU - Calderini, Edoardo Luigi
AU - Vigna, G.
AU - Santuz, Pierantonio
AU - Amigoni, A.
AU - Savron, Fabio
AU - Caramelli, Fabio
AU - Rossetti, Emanuele
AU - Cecchetti, Corrado
AU - Corbari, Maurizio
AU - Piastra, M.
AU - Testa, Raffaele
AU - Coffaro, Giancarlo
AU - Stancanelli, Giusi
AU - Gitto, E.
AU - Amato, Roberta
AU - Prinelli, Federica
AU - Salvo, I.
PY - 2016/1/27
Y1 - 2016/1/27
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.
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U2 - 10.1097/PCC.0000000000000657
DO - 10.1097/PCC.0000000000000657
M3 - Article
SN - 1529-7535
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
ER -