PRISM - SCORE EVALUATION TO PREDICT OUTCOME IN PEDIATRIC-PATIENTS ON ADMISSION AT AN EMERGENCY DEPARTMENT

This study was undertaken in order to evaluate for the first time the usefulness of PRISM score to predict outcome in pediatric patients in the Intensive Care Area of the Emergency Department at the Institute N acional de Pediatria in Mexico City. A protective evaluation of PRISM score was done using 100 consecutive pediatric patients admitted to IN P-ED between July and November 1992 and considered critically ill by t he attending pediatricians to calculate by a lineal logistic model the expected mortality and compare with the observed one. Using a cut-off of r = 0, we evaluated at the same time the sensitivity, specificity and efficiency of this score. Fifty-eight patients were male and 42 we re female. The mean age was 51 months with a range of 3 days -192 mont hs. PRISM score for survivors was in general 8.7 +/- 7.2 and 25.8 +/- 14 for nonsurvivors (p<0.001). Based on the logistic regression coeffi cients defined by Pollack et al., our sample of 100 patients was estim ated to expect 12.91 deaths whereas in fact 11 were observed. Inspecti on of the survival rates across the different categories of expected m ortality showed agreement and consistency in relation to original repo rts (9). The sensitivity, specificity and efficiency in general were 1 .0, 0.98 and 0.98, respectively. The PRISM is an objective and efficie nt method which helps physicians to predict patients' outcome and risk of mortality, providing the medical staff with an epidemiological cri teria. Additionally, it may be helpful in decision-making for ICU admi ssions and correct identification of patients who can benefit from tha t level of care.