Pediatric Index of Mortality 2 Score of Patients with Chest Problems in Pediatric Intensive Care Unit as an Indicator of Efficacy of Management and Personel Practice

Abstract

Background: The Pediatric Index of Mortality 2 (PIM 2) score is a predictive tool used to estimate the risk of mortality in pediatric  intensive care units (PICUs).

Objective: To evaluate the utility of the PIM 2 score in predicting mortality for this patient group, alongside examining management  strategies and personnel practices within a tertiary care PICU setting.

Methods: This prospective observational study was conducted at  Benha University Hospital's PICU over a six-month period from August 2022 to January 2023. A total of 98 children aged one month to 16  years presented with chest problems such as bronchitis, pneumonia, bronchial asthma, aspiration, and croup. PIM 2 score was calculated  based on ten critical variables such as elective PICU admission, early mechanical ventilation, systolic blood pressure, and base excess.  Patient outcomes were monitored until discharge.

Results: The study involved 98 patients, with an average age of 5.41 ± 3.121 years,  balanced across genders (46.9% male, 53.1% female). The average PIM 2 score was 9.58 ± 13.693, with patients' outcomes showing 86.7%  survival and 13.3% mortality. A significant correlation was found between higher PIM 2 scores and mortality (p < 0.001). ROC curve  analysis yielded a ≤15.7 PIM 2 score cut-off, predicting survival with 87.06% sensitivity and 84.62% specificity (AUC 0.902, p < 0.001)   

Conclusions: The PIM 2 score is a reliable predictor of mortality among pediatric patients with chest problems admitted to PICU. High  PIM 2 scores were significantly associated with increased mortality, underscoring the score's utility in clinical decision-making.