응급의료센터와 중환자실에서 소아 중환자의 예후인자 예측을 위한 PELOD Score와 PIM 2 Score의 유용성
The Values of the Pediatric Logistic Organ Dysfunction (PELOD) Score and the Pediatric Index of Mortality (PIM) 2 Score in Emergency Department and Intensive Care Unit
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Background: This study was conducted to compare two models of the pediatric logistic organ dysfunction (PELOD) score and the pediatric index of mortality (PIM) 2 score in the emergency department (ED) and intensive care unit (ICU). Methods: 90 pediatric patients who were admitted to the ICU in ED from January 2003 to December 2008 were enrolled in this study. PELOD score and PIM 2 score calculations were performed in the ED and ICU. We classified these patients into either the survivor or non-survivor groups and analyzed the clinical variables between two groups. We used Hosmer-Lemeshow goodness-of-fit tests to evaluate calibration, receiver operating characteristic (ROC) curves and standardized mortality ratio (SMR). Results: Among the 90 pediatric patients, 56 (62.2%) were male, and 9 (10.0%) patients died. Expected mortalities were PIM 2 = 10.35, PELOD = 8.33 in ED and PIM 2 = 8.84, PELOD = 8.26 in ICU. PIM 2 showed fit calibration (x2 = 6.228, p = 0.622) in the ED. In the ICU, both PELOD and PIM 2 showed calibration (x2 =4.625, p = 0.185) and (x2 = 7.616, p = 0.472), respectively. PIM 2 in ED showed the best discrimination, with area under the curve (AUC) = 0.949 (95% CI, 0.881−0.984). Conclusions: PIM 2 score in ED was fit. Also, PELOD and PIM 2 score in ICU was fit. But PELOD in ED was unfit.
Abstract
Background: This study was conducted to compare two models of the pediatric logistic organ dysfunction (PELOD) score and the pediatric index of mortality (PIM) 2 score in the emergency department (ED) and intensive care unit (ICU). Methods: 90 pediatric patients who were admitted to the ICU in ED from January 2003 to December 2008 were enrolled in this study. PELOD score and PIM 2 score calculations were performed in the ED and ICU. We classified these patients into either the survivor or non-survivor groups and analyzed the clinical variables between two groups. We used Hosmer-Lemeshow goodness-of-fit tests to evaluate calibration, receiver operating characteristic (ROC) curves and standardized mortality ratio (SMR). Results: Among the 90 pediatric patients, 56 (62.2%) were male, and 9 (10.0%) patients died. Expected mortalities were PIM 2 = 10.35, PELOD = 8.33 in ED and PIM 2 = 8.84, PELOD = 8.26 in ICU. PIM 2 showed fit calibration (x2 = 6.228, p = 0.622) in the ED. In the ICU, both PELOD and PIM 2 showed calibration (x2 =4.625, p = 0.185) and (x2 = 7.616, p = 0.472), respectively. PIM 2 in ED showed the best discrimination, with area under the curve (AUC) = 0.949 (95% CI, 0.881−0.984). Conclusions: PIM 2 score in ED was fit. Also, PELOD and PIM 2 score in ICU was fit. But PELOD in ED was unfit.
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