PREDICTION OF RISK OF MORTALITY IN PAEDIATRIC INTENSIVE CARE UNIT BY PRISM SCORE

Niha Peshimam; Keya Lahiri; Chinmay Chaudhari; Manisha Reddy

Volume : VIII, Issue : VII, July - 2019

PREDICTION OF RISK OF MORTALITY IN PAEDIATRIC INTENSIVE CARE UNIT BY PRISM SCORE

Niha Peshimam, Keya Lahiri, Chinmay Chaudhari, Manisha Reddy

Abstract :

Background: PRISM is the Paediatric risk of mortality score which has been devised by Pollock et.al. to predict the mortality in hospitalized children. PRISM score is a revised form of physiologic stability index of mortality score. Objectives: The primary objective was to determine the efficacy of Prism Score in critically ill patients, evaluating it as a simple bedside parameter, to study the outcome of critically ill patients using PRISM score and to prognosticate the mortality. Methods: Study was conducted at a Pediatric Intensive Care Unit (PICU) of a private tertiary care hospital in Navi Mumbai, for a total duration of 2 years (2012 – 2014), wherein 203 inpatients fulfilling the inclusion criteria were admitted. Sample size of the study was 203. A detailed history was taken, followed by thorough general and systemic examination and the details were entered in a predesigned proforma. All the inpatients were further evaluated by the following study variables which included 14 physiological variables of the score. Results: Of the 132 males and 71 females in the study, 108 males and 61 females survived. Maximum patients were > 36 months of age. Maximum cases (51) were of Respiratory System, followed by Central Nervous System, Infectious diseases and others. Maximum survivors (142) were with PRISM Scores 1 – 9, and maximum non–survivors (8) were with PRISM Score 20 – 29. The prediction of probability of death according to PRISM score of 5 was 4% and that of above 15 was > 50%. Conclusion: The goodness prediction by Hosmer – Lemeshow Goodness model showed that prediction of mortality by PRISM score to be highly significant. This study revealed that the prediction of probabilities of death in PICU significantly increased with increasing PRISM Score.