ORIGINAL ARTICLE

Risk adjusted mortality of critical illness in a defined geographical region

A J Henderson¹, L Garland¹, S Warne¹, L Bailey¹, P Weir¹, S Edees²

¹ Institute of Child Health, Bristol Royal Hospital for Children, UK
² Royal Berkshire Hospital, Reading, UK

Correspondence to:
Correspondence to:
Dr A J Henderson, Institute of Child Health, Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK;
a.j.henderson{at}bris.ac.uk

Aims: To evaluate the performance of the Paediatric Risk of Mortality (PRISM) score in a population of UK children and to use this score to examine severity of illness adjusted mortality of critically ill children <16 years old in a defined geographical region.

Methods: Observational study of a defined population of critically ill children (<16 years old) admitted to hospitals in the South West Region between 1 December 1996 and 30 November 1998.

Results: Data were collected from 1148 eligible admissions. PRISM was found to perform acceptably in this population. There was no significant difference between the overall number of observed deaths and those predicted by PRISM. Admissions with mortality risk 30% or greater had significantly greater odds ratio for death in general intensive care units compared with the tertiary paediatric intensive care unit.

Conclusions: Children with a high initial risk of mortality based on PRISM score were significantly more likely to survive in a tertiary paediatric intensive care unit than in general intensive care units in this region. However, there was no evidence from this study that admissions with lower mortality risk than 30% had significantly worse mortality in non-tertiary general units than in tertiary paediatric intensive care units.

Keywords: intensive care; hospital mortality; outcome assessment

Abbreviations: BPA, British Paediatric Association; ICU, intensive care unit; PICU, paediatric intensive care unit; PIM score, Paediatric Index of Mortality score; PRISM score, Paediatric Risk of Mortality score; ROC, receiver operator characteristic; TISS, therapeutic invervention scoring system

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This article has been cited by other articles:

• Fraser, J, Maskrey, C, Taylor, H (2004). Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units. Arch. Dis. Child. 89: 974-976 [Abstract] [Full Text]  

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