The Pediatric Risk of Mortality (PRISM) score and Injury Severity Score (ISS) for predicting resource utilization and outcome of intensive care in pediatric trauma
Fv. Castello et al., The Pediatric Risk of Mortality (PRISM) score and Injury Severity Score (ISS) for predicting resource utilization and outcome of intensive care in pediatric trauma, CRIT CARE M, 27(5), 1999, pp. 985-988
Objective: Mortality prediction in trauma is assessed using the Injury Seve
rity Score (ISS) and Revised Trauma Score using Trauma Injury Severity Scor
e (TRISS) methodology. The Pediatric Risk of Mortality (PRISM) score assess
es mortality risk in critically ill children. We compared the ability of PR
ISM and ISS (using TRISS methodology) to predict resource utilization and o
utcome in pediatric trauma,
Design: Retrospective chart and database review,
Setting: Pediatric intensive care unit (PICU),
Patients: Consecutive admissions to a PICU over a 2-yr period,
Measurements and Main Results: Demographic data including PICU resource uti
lization and outcome were recorded. Data were recorded on 1,052 admissions
(31 deaths), including 125 pediatric trauma patients (11 deaths). Patients
were stratified into low- and high-risk categories based on PRISM and ISS s
cores. Patients with PRISM scores <6 and ISS scores <10 were classified as
low risk, While both tow-risk PRISM and ISS scores readily identified survi
vors, PRISM was the more sensitive indicator of resource utilization, PRISM
, however, performed less well in determining risk adjusted mortality as co
mpared with ISS,
Conclusion: PRISM readily stratifies pediatric trauma patients for resource
utilization, PRISM appears to underestimate mortality in pediatric trauma
as compared with ISS using TRISS methodology.