Performance of Pediatric Index of Mortality II In Zagazig University Pediatric Intensive Care Unit

Objective: To evaluate the performance of Pediatric Index of Mortality II in predicting the mortality in children admitted to our pediatric intensive care unit Methods :This prospective cohort study included 200 patients of consecutive admissions to Zagazig University Children’s Hospital at its pediatric intensive care unit (PICU) during 6-month period. Patient aged from 2 monthS till 15 years old and stayed more than 8 hours alive in PICU were included in our study. All cases were subjected to taking a written consent from parents, full history taking, and complete clinical examination including mental status, vital signs, general examination & regional examination. Laboratory investigations including ABG were done and noted for each case. Final diagnosis and outcome were recorded. PIM II score variables were noted and score was calculated.Results : Over all the six months, the study included 200 patients admitted to PICU, with outcome of 101 survivors and 99 non-survivors. Mortality rate was 49.5%. The highest rates of admissions were in the patients presented with respiratory emergencies. There were significant differences between survivors and non survivors as regard the need for mechanical ventilation, oxygen saturation , response of pupils, and presence of high risk diagnosis. The mean value of predicted death rate by PIM II was 39.5 %, With highly significant difference between survivors and non survivors regarding this score (8.23 vs 62.28 respectively, p(0.001). The actual Mortality rate was 49.5% with standerized mortality ratio of 1.25 signifying poor performance of our PICU. PIM II score shows acceptable discrimination (area under ROC curve was 0.75) and moderate calibration (x2 = 15.75, p = 0.07, d = 8). Conclusion: PIM II score is a suitable mortality scoring tool in our PICU with acceptable discrimination and calibration. SMR is higher in our PICU than that in developed countries and this signify the need for improvement of standard of care in our PICU.