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Prognostic predictor at Pediatrics Intensive Care Unit (PICU) with Pediatric Risk of Mortality III (PRISM III) scores
ABSTRACT
Various mortality prognostic scoring system are available for predicting mortality risk in Pediatric Intensive Care Unit (PICU). The Pediatric Risk of Mortality III (PRISM III) scoring system is one of the main indicators used in the PICU. This study was conducted to evaluate the PRISM III as prognostic predictor in PICU. This was a cohort study involving 64 patients who admitted to PICU in Dr. Sardjito General Hospital, Yogyakarta and met inclusion and exclusion criteria.
The clinical state of patients were assessed and the PRISM III scores corresponding to the firs 24 hours of hospitalization were calculated. Outcome analysis was defined either as death or discharged from the hospital were recorded. Multivariate analysis was performed to find out independent predictive factor that influence the outcome of death. The discriminative power of the model was calculated based on the receiver operator curve (ROC).
The result showed that mental status ;relative risk/RR: 13.21; 95%Cl: 1.18-14.80), White Blood Count/WBC iRR: 19.51; 95%Cl: 18.12-25.151 and Blood Urea Nitrogen/BUN RR:22.87; 95%Cl:1.85-28.20) were found to be the main predictive factors of death in PICU. The cut off value of 51 of PRISM III score yielded the best sensitivity (83%1 and specificity (69%). In conclusion, PRISM III score can be used as a prognostic predictor to determine the death risk of patients hospitalized at PICU.
Keywords : prognostic - Pediatrics Intensive Care Unit - PRISM III - death risk – predictor
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