Revised Paediatric Index of Mortality (PIM2)

 

Patient selection: pediatric patient admitted to the intensive care unit (ICU)

 

Parameters:

(1) systolic blood pressure in mm Hg

(2) papillary reaction to light

(3) PaO2 to FIO2 ratio

(4) base excess in mmol/L

(5) mechanical ventilation

(6) elective admission to the ICU

(7) recovery after surgical procedure reason for ICU admission

(8) cardiac bypass procedure performed

(9) high risk diagnosis present

(10) low risk diagnosis present

 

Low risk diagnosis includes:

(1) asthma main reason for ICU admission

(2) bronchiolitis main reason for ICU admission

(3) croup main reason for ICU admission

(4) obstructive sleep apnea main reason for ICU admission

(5) diabetic ketoacidosis main reason for ICU admission

 

High risk diagnosis includes:

(1) cardiac arrest preceding ICU admission

(2) severe combined immune deficiency

(3) leukemia or lymphoma after first induction

(4) spontaneous cerebral hemorrhage

(5) cardiomyopathy or myocarditis

(6) hypoplastic left heart syndrome

(7) HIV infection

(8) liver failure main reason for ICU admission

(9) neuro-degenerative disorder

Parameter	Finding	Points
systolic blood pressure		absolute((pressure) – 120)
pupils fixed to light	no	0
	yes	1
PaO2 to FIO2		100 / (ratio)
base excess in mmol/L		absolute(value)
mechanical ventilation	no	0
	yes	1
elective admission	no	0
	yes	1
recovery after procedure	no	0
	yes	1
cardiac bypass performed	no	0
	yes	1
high risk diagnosis	none	0
	one or more	1
low risk diagnosis	none	0
	one or more	1

 

where:

• The default value for systolic blood pressure is 120 if the value is not known.

 

X =

= (0.01579 * (points for systolic blood pressure)) + (2.7044 * (points for pupils)) + 0.2620 * (points for PaO2 to FIO2 ratio)) + (0.1129 * (points for base excess)) + (1.2859 * (points for mechanical ventilation)) – (0.8196 * (points for elective admission)) – (1.0423 * (points for points for recovery after surgery)) + (0.7* (points for bypass)) + (1.4907 * (points for high risk diagnosis)) – (1.5572 * (points for low risk diagnosis)) – 4.8864

 

probability of death =

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