Background and Aims PIM2 score gives the risk score for specific clinical disease condition. We studied the profile of patients admitted in PICU and validated PIM2 score in our tertiary care setting.
Methods Detailed evaluation of patients admitted to the PICU between January 2010 and December 2011 was done for presenting signs and symptoms, management by trauma team and pediatric team and the appropriateness of the intereventions were recorded till the child had spent 24 hours in the hospital. Outcomes were death, discharge and DAMA. The PIM2 scoring was done at the time of admission. Data was analyzed by Logistic regression and ROC curve analysis.
Results Of 742 consecutive admissions (295 females and 447 males, 39.08% infants), 35.84% patients were mechanically ventilated and mortality was 7%. Significant anemia (27.2%), pneumonia (19.5%), meningitis/encephalitis (17.1%), septicemia and septicemic shock (29.5%) were seen. 25.6% patients admitted in PICU took discharge against medical advice due to unaffordable medical care. Sensitivity of PIM2 score was 65.7%, and specificity was 70.6% at cut-off point of 1.9. Predictive capability as assessed by calculating the area under ROC curve was 0.724 (95% CI 0.69 to 0.76). Logistic Regression analysis revealed that age, shock, Protein energy malnutrition, multiple organ dysfunction syndrome, meningitis/encephalitis, adherence to guidelines, ventilatory support requirement are significant predictors of Mortality.
Conclusions Infectious diseases were the most common cause of PICU admissions and mortality. PIM2 scoring did not correlate well with outcome suggesting need of recalibration. Following published emergency guidelines was associated with significantly better outcome.