Overall and subgroup specific performance of the pediatric index of mortality 2 score in Switzerland: a national multicenter study.
Journal article

Overall and subgroup specific performance of the pediatric index of mortality 2 score in Switzerland: a national multicenter study.

  • Polito A Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, 6 rue Willy Donzé, CH-1211, Geneva, Switzerland. angelo.polito@hcuge.ch.
  • Giacobino C Division of Clinical Epidemiology, Faculty of Medicine, University of Geneva, and Geneva University Hospitals, 6 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland.
  • Combescure C Division of Clinical Epidemiology, Faculty of Medicine, University of Geneva, and Geneva University Hospitals, 6 rue Gabrielle-Perret-Gentil, CH-1211, Geneva, Switzerland.
  • Levy-Jamet Y Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, 6 rue Willy Donzé, CH-1211, Geneva, Switzerland.
  • Rimensberger P Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, 6 rue Willy Donzé, CH-1211, Geneva, Switzerland.
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  • 2020-04-03
Published in:
  • European journal of pediatrics. - 2020
English Pediatric Index of Mortality (PIM) 2 score is used in pediatric intensive care unit (PICU) to predict the patients' risk of death. The performance of this model has never been assessed in Switzerland. The aim of this study was to evaluate the performance of the PIM2 score in the whole cohort and in pre-specified diagnostic subgroups of patients admitted to PICUs in Switzerland. All children younger than 16 years admitted to any PICU in Switzerland between January 1, 2012 and December 31, 2017 were included in the study. A total of 22,382 patients were analyzed. Observed mortality was 2%, whereas mortality predicted by PIM2 was 4.2% (SMR = 0.47, 95% CI, 0.42-0.52). Calibration was also poor across the deciles of mortality risks (p < 0.001). The AUC-ROC for the entire cohort was 0.88 (95% CI, 0.87-0.90). Calibration varied significantly according to primary diagnosis.Conclusion: The performance of the PIM 2 score in a cohort of Swiss patients is poor with adequate discrimination and poor calibration. The PIM 2 score tends to under predict the number of deaths among septic patients and in patients admitted after a cardiorespiratory arrest. What is Known: •PIM2 score is a widely used mortality prediction model in PICU. •PIM2 performance among uncommon but clinically relevant diagnostic subgroups of patients is unknown. •The performance of PIM2 score has never been assessed in Switzerland. What is New: •The performance of the PIM 2 score in a cohort of Swiss patients is poor with adequate discrimination and poor calibration. •Calibration varies significantly according to primary diagnosis. The PIM 2 score under predict the number of deaths among septic patients and in patients admitted after a cardiorespiratory arrest.
Language
  • English
Open access status
closed
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Persistent URL
https://sonar.ch/global/documents/194325
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