Paediatric Index of Mortality 3: An Updated Model for Predicting Mortality in Pediatric Intensive Care
Paediatric Index of Mortality 3: An Updated Model for Predicting Mortality in Pediatric Intensive Care
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DOI：
10.1097/pcc.0b013e31829760cf
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发表时间：
2013-09-01
影响因子：
4.1
通讯作者：
Slater, Anthony
中科院分区：
文献类型：
--
作者：
Straney, Lahn;Clements, Archie;Slater, Anthony
目的：提供儿科死亡率指数2的更新版，用于评估入住ICU的儿童的死亡风险。设计：国际、多中心、前瞻性队列研究。背景：60个在澳大利亚、新西兰、爱尔兰和英国接受儿科住院的ICU。患者：所有在2010年和2011年入院时年龄在18岁以下且在ICU中死亡或已出院的儿童。被转移到另一个ICU的患者不包括在内。53,112例入院患者纳入分析。干预：无。测量和主要结果：使用Logistic回归建立了修订的预测模型。变量的选择是基于95%水平上的显着性和模型的判别性能和拟合优度的总体改进。最终的模型具有很好的区分性(曲线下面积为0.88，0.88-0.89)；然而，该模型在澳大利亚和新西兰的表现好于英国和爱尔兰(曲线下面积分别为0.91，0.90-0.93和0.85，0.84-0.86)。结论：儿科死亡率指数3提供了一个基于大量当代数据集的国际标准，用于比较重症监护患儿的风险调整后死亡率。
Objectives: To provide an updated version of the Paediatric Index of Mortality 2 for assessing the risk of mortality among children admitted to an ICU.Design: International, multicenter, prospective cohort study.Setting: Sixty ICUs that accept pediatric admissions in Australia, New Zealand, Ireland, and the United Kingdom.Patients: All children admitted in 2010 and 2011 younger than 18 years old at the time of admission and either died in ICU or were discharged. Patients who were transferred to another ICU were not included. Fifty-three thousand one hundred twelve patient admissions were included in the analysis.Interventions: None.Measurement and Main Results: A revised prediction model was built using logistic regression. Variable selection was based on significance at the 95% level and overall improvement of the model's discriminatory performance and goodness of fit. The final model discriminated well (area under the curve, 0.88, 0.88-0.89); however, the model performed better in Australia and New Zealand than in the United Kingdom and Ireland (area under the curve was 0.91, 0.90-0.93 and 0.85, 0.84-0.86, respectively).Conclusions: Paediatric Index of Mortality 3 provides an international standard based on a large contemporary dataset for the comparison of risk-adjusted mortality among children admitted to intensive care.