Use of PRISM III scoring for mortality prediction in a tertiary care centre of Rohilkhand region

Abstract

Objective: Paediatric Risk of Mortality (PRISM III) score is a frequently used, physiologically based severity of illness measure, commonly used to control for severity of illness. It is significantly associated with morbidity and mortality and could be used to simultaneously estimate morbidity and mortality risk within the first 24 hours of admission in PICU. Predicting the outcome of any serious illness is of utmost importance for the planning and assessment of interventions in the health-care system, as well as for providing a prognosis for individual cases to the caregivers. Therefore, this study intends to evaluate the efficacy of PRISM III score in prediction of disease specific mortality rate in PICU. Methods: In this prospective, hospital based observational study, 107 children fulfilled the required criteria and were enrolled. PRISM III score was calculated using variables in the first 24 hours after admission. Outcome was noted as survivors and non-survivors. Results: A total of 107 patients were enrolled in the study. Out of 107 patients, 27 were non-survivors, with the mortality rate of 25%. The median PRISM III score was not found to be significantly different between survivors and non-survivors but the use of PRISM III score along with the need of mechanical ventilation and ionotropic support in the first 24 hrs of admission significantly predicted mortality. Overall, PRISM III score did help in severity assessment at the time of admission and the need of mechanical ventilation and ionotropic support. Conclusion: In patients with hepatobiliary and CNS dysfunction PRISM III – 24 score could not predict mortality but it can be applied for severity assessment at the time of admission to PICU. PRISM III24 score proved to be a good predictor of mortality for children admitted with septicaemia, nephrology, respiratory dysfunction.