ABSTRACT 976

Abstract

Background and aims: The Pediatric index of mortality (PIM) and PIM-2 have been extensively validated and have shown to perform well across units from developed countries. However, results from units from developing countries have not been so encouraging owing to inadequate numbers evaluated. Aims: The aim of our study was to evaluate the performance of our unit using the PIM and PIM2 models using recommended sample size for such estimation. Methods: We prospectively recorded the baseline characteristics, variables of PIM and PIM2 at admission, and outcome of children admitted to our ICU from Jan 2012 to September 2013. The discriminative ability of the models was evaluated by the area under the ROC curves, and calibration by the Hosmer-Lemeshow goodness of fit (GOF) and standardized mortality ratio (SMR). The study was approved by the IRB. Results: Of the 904 admissions, 253 (28%) died. The major reasons for ICU admission as well as mortality were sepsis/severe sepsis and cardiac illnesses. The area under ROC curves for PIM and PIM2 were 0.74 (95% CI: 0.70-0.78) and 0.76 (95% CI: 0.70-0.80) respectively. The GOF test showed a good calibration across deciles of risk for the two scores with p values being >0.05. The SMR (95% CI) was 0.99 (0.85-1.15) and 1 (0.85-1.16) for PIM and PIM2 respectively. The calibration across different age and diagnostic subgroups was also good. Conclusions: The performance of our unit appeared to be similar to the units where the PIM and PIM2 models were developed. Our results however, need careful interpretation as the models were developed almost a decade earlier.