Abstract

MORENO, Rodolfo P. et al. Características de la población y aplicación de puntajes pronósticos en una nueva unidad de cuidados intensivos pediátricos. Arch. argent. pediatr. [online]. 2005, vol.103, n.5, pp.406-413. ISSN 0325-0075.

Introduction. Before supplying pediatric intensive care and assessment of needs, efficiency and efectiveness is needed. The use of prognosis scores is one of the ways to achieve such an assessment. The prognosis scores most used in pediatrics are: Pediatric Risk of Mortality (PRISM) y Paediatric Index of Mortality (PIM). Objectives. 1. To determine the characteristics of the population at the pediatric intensive care unit during the first two years of functioning. 2. To categorize death risk of patients. 3. To compare the observed mortality with the expected mortality, according to PRISM and PIM scores in the whole population and in several subgroups. Population, material and methods. Inclusion criteria: all patients admitted to our pediatric intensive care unit were included between 01/01/01 to 31/12/02. Demographic variables were analyzed and PRISM and PIM scores were collected for each patient comparing calculated and observed mortality. Results. There were 243 admissions. Mean age was 12 months (range 1-192). Sex distribution was: males 59.2% and females 40.7%. Average length of stay was 10.1 days. Referred from the emergency room 34.2%, from pediatrics ward 30.5%, from other hospitals 24.8%, from Surgery department 8.2% and from Neonatology 2.4%. Admission diagnoses: respiratory tract disorders 39.1%, trauma 16%, postoperative 11.5%, septic shock 10.3%, neurologic disorders 9%, cardiovascular disease 6.2%, miscellaneous 7.8%. Mechanical ventilation was required in 109 patients (44.8%) The mean of PRISM was 16% (range 0 - 98). In 20 cases PRISM could not be performed since length of stay was lower than the 24 hours required for it; among these there were 7 deaths. Expected mortality was 34.8% and standardized mortality ratio (SMR) was 0.71. PIM was performed in every admission. Crude mortality rate (CMR%) was 13.2% (32 patients), probability of death (POD) was 26 and the SMR was 1.22. Conclusions. 1) The survival of admitted patients at our PICU was 86.8%. 2) The most frequent cause of admission was respiratory tract disorders. 3) Most of the patients were referred from the emergency room and from the pediatrics ward. 4) In our series, the mean of PRISM is higher than those reported but the observed mortality rate is comparable to other pediatric intensive care units in Argentina.

Keywords : Pediatric intensive care; Mortality; Scores; PRISM; PIM.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )