scholarly journals Perbandingan Penggunaan Pediatric Index of Mortality 2 (PIM2) dan Skor Pediatric Logistic Organ Dysfunction (PELOD), Untuk memprediksi kematian pasien sakit kritis pada anak

Sari Pediatri ◽  
2016 ◽  
Vol 10 (4) ◽  
pp. 262
Author(s):  
Linda Marlina ◽  
Dadang Hudaya S ◽  
Herry Garna
Keyword(s):  
Receiver Operating Characteristic ◽  
Organ Dysfunction ◽  
Severity Score ◽  
Goodness Of Fit ◽  
Operating Characteristic ◽  
Goodness Of Fit Test ◽  
Logistic Organ Dysfunction ◽  
Risk Of Mortality ◽  
Pediatric Index Of Mortality ◽  
Receiver Operating

Latar belakang. Penilaian derajat kesakitan (severity score of illness) telah dikembangkan sejalan dengan meningkatnyaperhatian terhadap evaluasi dan pemantauan pelayanan kesehatan. Skor yang telah dikembangkanuntuk anak adalah pediatric logistic organ dysfunction, pediatric risk of mortality, dan pediatric index ofmortality.Tujuan. Membandingkan ketepatan pediatric index of mortality-2 dengan skor pediatric logistic organdysfunction dalam memprediksi kematian pasien sakit kritis pada anak.Metode. Rancangan observasi longitudinal dengan subjek penelitian anak yang menderita sakit kritis, dirawatdi Bagian Ilmu Kesehatan Anak RSHS pada bulan Februari-Mei 2008. Dilakukan anamnesis, pemeriksaanfisis, dan laboratorium untuk mendapatkan pediatric index of mortality 2 dan skor pediatric logistic organdysfunction. Analisis statistik dengan menggunakan receiver operating characteristic (ROC) untuk menilaidiskriminasi dan Hosmer-Lemeshow goodness-of-fit untuk menilai kalibrasi.Hasil. Didapatkan 1215 anak berobat ke Bagian Ilmu Kesehatan Anak RS Hasan Sadikin Bandung, 120di antaranya merupakan pasien kritis. Pediatric index of mortality 2 memberikan hasil diskriminasi yanglebih baik (ROC 0,783; 95% CI 0,688–0,878) dibandingkan dengan pediatric logistic organ dysfunction(ROC 0,706; 95% CI 0,592–0,820). Pediatric index of mortality-2 memberikan hasil kalibrasi yang baik(Hosmer-Lemeshow goodness-of-fit test p=0,33; SMR 0,85) dibandingkan pediatric logistic organ dysfunction(p=0,00; SMR 1,37). PIM2 dan skor PELOD mempunyai korelasi positif dihitung dengan menggunakanSpearman’s correlation, r=0,288 (p=0,001).Kesimpulan. Pediatric index of mortality-2 memiliki kemampuan diskriminasi dan kalibrasi lebih baikdibandingkan dengan pediatric logistic organ dysfunction.

scholarly journals Perbandingan Pediatric Logistic Organ Dysfunction dan Pediatric Risk of Mortality III Sebagai Prediktor Kematian Sindrom Syok Dengue di Ruang Rawat Intensif Anak

Sari Pediatri ◽  
2016 ◽  
Vol 12 (6) ◽  
pp. 440
Author(s):  
Henny Rosita Iskandar ◽  
Dharma Mulyo ◽  
Antonius Pudjiadi ◽  
Agnes Pratiwi ◽  
Yuliatmoko Suryatin
Keyword(s):  
Receiver Operating Characteristic ◽  
Organ Dysfunction ◽  
Operating Characteristic ◽  
Logistic Organ Dysfunction ◽  
Risk Of Mortality ◽  
Receiver Operating

Latar belakang. Sindrom syok dengue (SSD) merupakan bentuk demam berdarah dengue (DBD) berat.Mortalitas SSD pada Rumah Sakit Anak dan Bunda Harapan Kita (RSAB HK) cukup tinggi ( 13,2% ).Tujuan. Menilai perbandingan pediatric logistic organ dysfunction (PELOD) dan pediatric risk of mortality(PRISM) III sebagai prediktor kematian SSD pada anak yang dirawat di ruang perawatan intensif anak.Metode. Penelitian prospektif, 41 anak dengan SSD yang dirawat di ruang perawatan intensif dari bulanJanuari - Desember 2006 di RSAB HK dilibatkan dalam penelitian. Diagnosis SSD ditegakkan berdasarkankriteria WHO tahun 1997 dan dikonfirmasi dengan serologi positif Dengue Blot yang dilakukan pada harikelima demam. Perhitungan skor PELOD and PRISM III dilakukan dari hasil pemeriksaan pada haripertama masuk ruang rawat intensif.Hasil. Terdapat 41 subyek yang diteliti, umur dari 8 sampai 180 bulan. Kematian terjadi pada 5 anak(12,1%). Rerata skor PELOD anak yang meninggal 22,2 dan yang hidup 7,7 sedangkan rerata skor PRISMIII anak yang meninggal 22 dan yang hidup 9,4. Analisa skor PELOD dan PRISM III menurut Mann-Whitney U test terdapat perbedaan bermakna antara anak yang meninggal dan hidup dengan p = 0,001untuk PELOD dan p=0,005 untuk PRISM III. Kurva receiver operating characteristic (ROC) dengan CI95% 0,953 untuk PELOD dan 0,889 untuk PRISM III.Kesimpulan. Skor PELOD dan PRISM III merupakan alat yang baik untuk memprediksi kematian pasienanak SSD yang dirawat di ruang intensif anak. Skor PELOD sedikit lebih baik dari skor PRISM III.

Predictive Performance and Variability of the Cardiac Anesthesia Risk Evaluation Score

2004 ◽  
Vol 100 (6) ◽  
pp. 1405-1410 ◽  
Author(s):  
Alexandre Ouattara ◽  
Michaëla Niculescu ◽  
Sarra Ghazouani ◽  
Ario Babolian ◽  
Marc Landi ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Risk Evaluation ◽  
Goodness Of Fit ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Performance ◽  
Cardiac Anesthesia ◽  
Goodness Of Fit Test ◽  
Significant Difference ◽  
Receiver Operating

Background The Cardiac Anesthesia Risk Evaluation (CARE) score, a simple Canadian classification for predicting outcome after cardiac surgery, was evaluated in 556 consecutive patients in Paris, France. The authors compared its performance to those of two multifactorial risk indexes (European System for Cardiac Operative Risk Evaluation [EuroSCORE] and Tu score) and tested its variability between groups of physicians (anesthesiologists, surgeons, and cardiologists). Methods Each patient was simultaneously assessed using the three scores by an attending anesthesiologist in the immediate preoperative period. In a blinded study, the CARE score category was also determined by a cardiologist the day before surgery, by a surgeon in the operating room, and by a second anesthesiologist at arrival in intensive care unit. Calibration and discrimination for predicting outcomes were assessed by goodness-of-fit test and area under the receiver operating characteristic curve, respectively. The level of agreement of the CARE scoring between the three physicians was then assessed. Results The calibration analysis revealed no significant difference between expected and observed outcomes for the three classifications. The areas under the receiver operating characteristic curves for mortality were 0.77 with the CARE score, 0.78 with the EuroSCORE, and 0.73 with the Tu score (not significant). The agreement rate of the CARE scoring between two anesthesiologists, between anesthesiologists and surgeons, and between anesthesiologists and cardiologists were 90%, 83%, and 77%, respectively. Conclusions Despite its simplicity, the CARE score predicts mortality and major morbidity as well the EuroSCORE. In addition, it remains devoid of significant variability when used by groups of physicians of different specialties.

scholarly journals Comparison of Pediatric Risk of Mortality III, Pediatric Index of Mortality 2, and Pediatric Index of Mortality 3 in Predicting Mortality in a Pediatric Intensive Care Unit

2018 ◽  
Vol 07 (04) ◽  
pp. 201-206 ◽  
Author(s):  
Priyamvada Tyagi ◽  
Mukesh Agrawal ◽  
Milind Tullu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Roc Curve ◽  
Goodness Of Fit ◽  
Pediatric Intensive Care ◽  
Goodness Of Fit Test ◽  
Risk Of Mortality ◽  
Pediatric Index Of Mortality ◽  
Good Calibration

Aims To compare and validate the Pediatric Risk of Mortality (PRISM) III, Pediatric Index of Mortality (PIM) 2, and PIM 3 scores in a tertiary care pediatric intensive care unit (PICU) (Indian setting). Materials and Methods All consecutively admitted patients in the PICU of a public hospital (excluding those with unstable vital signs or cardiopulmonary resuscitation within 2 hours of admission, cardiopulmonary resuscitation before admission, and discharge or death in less than 24 hours after admission) were included. PRISM III, PIM 2, and PIM 3 scores were calculated. Mortality discrimination for the three scores was calculated using the receiver operating characteristic (ROC) curve, and calibration was performed using the Hosmer–Lemeshow goodness-of-fit test. Results A total of 350 patients were included (male:female = 1.3:1) over the study duration of 18 months (median age: 12 months [interquartile range: 4–60 months]). Nearly half were infants (47.4%). Patients with central nervous system disease were the highest (22.8%) followed by cardiovascular system (20.6%). Mortality rate was 39.4% (138 deaths). The area under the ROC curve for the PRISM III score was 0.667, and goodness-of-fit test showed no significant difference between the observed and expected mortalities in any of these categories (p > 0.5), showing good calibration. Areas under the ROC curve for the PIM 2 and PIM 3 scores were 0.728 and 0.726, respectively. For both the scores, the goodness-of-fit test showed good calibration. Conclusions Although all the three scores demonstrate good calibration, the PIM 2 and PIM 3 scores have an advantage regarding the better discrimination ability, ease of data collection, simplicity of computation, and inherent capacity of not being affected by treatment in PICU.

scholarly journals New PELOD-2 cut-off score for predicting death in children with sepsis

2021 ◽  
Vol 61 (1) ◽  
pp. 39-45
Author(s):  
Ni Made Rini Suari ◽  
Abdul Latief ◽  
Antonius H. Pudjiadi
Keyword(s):  
Organ Dysfunction ◽  
Goodness Of Fit ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Organ Damage ◽  
Goodness Of Fit Test ◽  
Logistic Organ Dysfunction ◽  
Life Threatening ◽  
Definition Of ◽  
Pediatric Sepsis

Background According to the most recent Sepsis-3 Consensus, the definition of sepsis is life-threatening organ dysfunction caused by dysregulated immune system against infection. Currently, one of the most commonly used prognostic scoring system is pediatric logistic organ damage-2 (PELOD-2) score. Objective To determine and validate the pediatric logistic organ dysfunction-2 (PELOD-2) cut-off score to predict mortality in pediatric sepsis patients. Methods A prospective cohort study was conducted in the intensive care units of Cipto Mangunkusumo Hospital, Jakarta. We assessed subjects with PELOD-2 and calculated the predicted death rate (PDR) using SFAR software. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate calibration and the area under the curve (AUC) of the receiver operating characteristic curve (ROC) to estimate discrimination. Results Of 2,735 children admitted to the emergency department, 52 met the inclusion criteria. Patients had various types of organ dysfunction: 53.8% respiratory, 28.8% neurological, 15.4% cardiovascular, 1.9% hematological. The mortality rate in this study was 38.5%. Mean PELOD-2 score was higher in patients who died than in those who survived [13.9 (SD 4.564) vs. 7.59 (SD 3.025), respectively, P=0.000]. The discrimination of PELOD-2 score with the lactate component had an AUC of 85.5% (95%CI 74.5 to 96.5), while PELOD-2 without lactate had an AUC of 85.4% (95%CI 74.5 to 96.3%). We propose a new PELOD-2 cut-off score to predict organ dysfunction and death of 10, with 75% sensitivity, 72% specificity, 62.5% PPV, and 82% NPV. PELOD-2 score > 10 had a moderate, statistically significant correlation to mortality (r=0.599; P<0.001). Conclusion A PELOD-2 score > 10 is valid for predicting life-threatening organ dysfunction in pediatric patients with sepsis.

scholarly journals Validation of Pediatric Index of Mortality 3 in a Single Referral Pediatric Intensive Care Unit in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hossein Saidi ◽  
Hamed Basir Ghafouri ◽  
Hamed Aghdam ◽  
Ghamartaj Khanbabaei ◽  
Narges Ahmadizadeh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Pediatric Intensive Care Unit ◽  
Goodness Of Fit ◽  
Pediatric Intensive Care ◽  
Goodness Of Fit Test ◽  
Young Infants ◽  
Risk Of Mortality ◽  
Pediatric Index Of Mortality

Objectives: The research aimed to evaluate the Pediatric Index of Mortality 3 (PIM-3) for determining the risk of mortality among pediatric intensive care unit patients. Methods: A retrospective analysis was conducted on case records, as well as patient data from all admissions to the PICU of Mofid Children’s Hospital, Tehran, from October 2017 to February 2018. Employing an android calculator application, the PIM-3 score was estimated early within the first PICU admission. Then, the PIM-3 score and mortality rate were analyzed using the Mann-Whitney U test. In addition, calibration and discrimination were assessed by the Hosmer-Lemeshow goodness-of-fit test and a receiver operating characteristic curve method, respectively. Finally, the Standardized Mortality Ratio (SMR) was calculated. Results: In this study, 365 young infants, ranging from 10 to 29-months-old, were included. The overall mortality rate was 10.4%. Further, the patients’ PIM-3 scores ranged from 0.06% to 2.37% (95% confidence interval), with a mean of 1.45% (4.16% in non-survivors and 1.14% in survivors). The SMR was estimated at 7.18, demonstrating the underprediction of the death rate. The AUC of 0.714 (95% CI: 0.626 to 0.801) demonstrated a fair to good discrimination power of PIM-3 as an international standard risk-adjusted mortality indicator. Moreover, this score underpredicted the risk of mortality in young infants admitted to our ICU in 2017. Generally, the prediction was weak among low-risk patients. Therefore, the Pediatric Index of Mortality-3 score has the potential to be implemented in our PICU by modifying the expected probability of death by multiplying the original PIM-3 score by 7.12.

Übereinstimmung von klinischer Diagnose, strukturierten Interviews und Selbstbeurteilungsfragebögen bei Depression im Kindes- und Jugendalter

2012 ◽  
Vol 40 (6) ◽  
pp. 405-414 ◽  
Author(s):  
Kathrin Dolle ◽  
Gerd Schulte-Körne ◽  
Nikolaus von Hofacker ◽  
Yonca Izat ◽  
Antje-Kathrin Allgaier
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Kinder Und Jugendliche ◽  
Prädiktive Werte ◽  
Receiver Operating

Fragestellung: Die vorliegende Studie untersucht die Übereinstimmung von strukturierten Kind- und Elterninterviews sowie dem klinischen Urteil bei der Diagnostik depressiver Episoden im Kindes- und Jugendalter. Zudem prüft sie, ob sich die Treffsicherheit und die optimalen Cut-off-Werte von Selbstbeurteilungsfragebögen in Referenz zu diesen verschiedenen Beurteilerperspektiven unterscheiden. Methodik: Mit 81 Kindern (9–12 Jahre) und 88 Jugendlichen (13–16 Jahre), die sich in kinder- und jugendpsychiatrischen Kliniken oder Praxen vorstellten, und ihren Eltern wurden strukturierte Kinder-DIPS-Interviews durchgeführt. Die Kinder füllten das Depressions-Inventar für Kinder und Jugendliche (DIKJ) aus, die Jugendlichen die Allgemeine Depressions-Skala in der Kurzform (ADS-K). Übereinstimmungen wurden mittels Kappa-Koeffizienten ermittelt. Optimale Cut-off-Werte, Sensitivität, Spezifität sowie positive und negative prädiktive Werte wurden anhand von Receiver operating characteristic (ROC) Kurven bestimmt. Ergebnisse: Die Interviews stimmten untereinander sowie mit dem klinischen Urteil niedrig bis mäßig überein. Depressive Episoden wurden häufiger nach klinischem Urteil als in den Interviews festgestellt. Cut-off-Werte und Validitätsmaße der Selbstbeurteilungsfragebögen variierten je nach Referenzstandard mit den schlechtesten Ergebnissen für das klinische Urteil. Schlussfolgerungen: Klinische Beurteiler könnten durch den Einsatz von strukturierten Interviews profitieren. Strategien für den Umgang mit diskrepanten Kind- und Elternangaben sollten empirisch geprüft und detailliert beschrieben werden.

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