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BioMed Research International
Volume 2014, Article ID 907871, 7 pages
http://dx.doi.org/10.1155/2014/907871
Research Article

Pediatric Index of Mortality and PIM2 Scores Have Good Calibration in a Large Cohort of Children from a Developing Country

1Department of Pediatrics, PGIMER, Dr. R.M.L Hospital, New Delhi 110001, India
2Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India

Received 28 February 2014; Accepted 20 May 2014; Published 15 June 2014

Academic Editor: Jens Möller

Copyright © 2014 Jhuma Sankar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Our objective was to validate the Pediatric Index of Mortality (PIM) and PIM2 scores in a large cohort of children from a developing country. Design. Prospective observational study. Setting. Pediatric intensive care unit of a tertiary care teaching hospital. Patients. All children aged <18 years admitted between June 2011 and July 2013. Measurements and Main Results. We evaluated the discriminative ability and calibration as measured by the area under the receiver operating characteristic (ROC) curves, the Hosmer-Lemeshow goodness-of-fit (GOF), and standardized mortality ratio (SMR), respectively. Of the 819 children enrolled, 232 (28%) died. The median (IQR) age of the study subjects was 4 years (0.8, 10). The major reasons for ICU admission as well as mortality were sepsis/severe sepsis. The area under ROC curves for PIM and PIM2 was 0.72 (95% CI: 0.67–0.75) and 0.74 (95% CI: 0.70–0.78), respectively. The goodness-of-fit test showed a good calibration across deciles of risk for the two scores with 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. Conclusion. PIM and PIM2 scores had good calibration in our setup.