Paediatric Index of Mortality (PIM) for Children Receiving Intensive Care

 

Ages of the patients: < 16 years of age

 

Data collection: at time of admission to the ICU

 

Parameters:

(1) pupils fixed to light (both > 3 mm in a bright light and fixed)

(2) specific diagnosis

(3) elective admission

(4) mechanical ventilation

(5) systolic blood pressure

(6) base excess

(7) FIO2 and PaO2

 

Parameter	Finding	Points
both pupils fixed to light	yes	1
	no	0
specific diagnosis	yes	1
	no	0
elective admission	yes	1
	no	0
mechanical ventilation	yes	1
	no	0
systolic blood pressure (SBP) in mm Hg		ABSOLUTE ((SBP) – 120)
base excess in mmol/L		ABSOLUTE (base excess)
FIO2 and PaO2		(100 * (FIO2)) / (PaO2 in mm Hg)

 

where:

• "Absolute" indicates taking the absolute value for the expression.

• FIO2 is the fractional inspired oxygen concentration, ranging from 021 to 1.00

• If a value was unknown, then it is assumed to be 0, except for systolic blood pressure which is set to 120 (making the expression equal to 0).

 

X =

= (2.357 * (points for pupils)) + (1.826 * (points for specific diagnosis)) - (1.552 * (points for elective admission)) + (1.342 * (points for mechanical ventilation)) + (0.021 * (points for SBP)) + (0.071 * (points for base excess)) + (0.415 * (points for FIO2 and PaO2)) – 4.873

 

where:

• The coefficients used are those from the entire fourth study sample of 5,695 patients. Coefficients from the test group of 3,370 patients differ.

 

probability of mortality =

= 1 / (1 + (EXP((-1) * X)))

 

Performance:

• Area under the ROC curve 0.90

• Deciles of risk goodness of fit test p = 0.37