Professional paper
Standardized mortality rate in groups of patients treated in a pediatric intensive care unit
Julije Meštrović
; Jedinica intenzivnog liječenja djece, Klinika za dječje bolesti, KBC Split, Split, Hrvatska
Tatjana Čatipović
; Ustanova za hitnu medicinsku pomoć, Split, Hrvatska
Branka Polić
; Jedinica intenzivnog liječenja djece, Klinika za dječje bolesti, KBC Split, Split, Hrvatska
Joško Markić
; Jedinica intenzivnog liječenja djece, Klinika za dječje bolesti, KBC Split, Split, Hrvatska
Goran Kardum
; Katedra za neuroznanost, Medicinski fakultet Sveučilišta u Splitu, Split, Hrvatska
Abstract
The composition of patient population in pediatric intensive care units may vary significantly. The differences in composition between original population based on which the system was derived and patient population on whom the mortality rate forecast system is applied, as on certain groups within the population, make the accuracy of mortality predictions unreliable. We collected factors for calculation of Paediatric Index of Mortality (PIM 2) system for 591 patients consecutively admitted to pediatric intensive care unit (PICU). We separately calculated observed mortality (OM), predicted mortality (PM) and standardized mortality rate (SMR) for different groups of patients. PM was higher than OM for surgical patients, as well as for emergency patients. Within diagnostic groups, SMR was < 1 for neurological patients, and for patients with respiratory tract diseases > 1. Within age groups, SMR was > 1 in preschool children, and < 1 in adolescents. Hospitalization duration analysis has shown that SMR was > 1 in longterm hospitalized patients. Predictive ability of PIM2 system is, therefore not equal for all groups within patient population. Meaning, the difference in patient population composition can be the cause of less precise calculation of PM compared to OM. This problem can be more expressed in units with smaller and uniform patient populations.
Keywords
child; intensive care; disease severity; scoring system
Hrčak ID:
50610
URI
Publication date:
12.9.2009.
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