A study on the prediction of illness related mortality of critically ill children by applying paediatric risk mortality III score in paediatric medical intensive care unit patients

Background: Prognostic scoring systems are increasingly used to predict risk of mortality by assessing severity of illness on the day of admission. The paediatric risk mortality III (PRISM III) score is one of the mortality score systems which is commonly used among paediatric critical care units.

Objectives: To assess the severity of illness using PRISM III score in all paediatric medical intensive care unit (MICU) admissions within the first 24 hours and to find the relationship between PRISM III score and the mortality rate.

Method: This was a prospective study conducted at MICU, Sirimavo Bandaranaike Specialized Children Hospital, Peradeniya from July 2016 to April 2017. PRISM III score of each patient was calculated from abnormal physical and laboratory variables according to scoring system on admission day and the patients followed up for their outcome.

Results: The sample size was 105 with 51 males and 54 females. There were 23 deaths and 82 discharges from MICU. There was significant positive correlation with death and provision of mandatory ventilation or usage of any number of inotropes. The average PRISM III score among the sample was 8.1. The PRISM III scores among the deaths and survivals were 14.6 and 6.3 respectively. 

Conclusions: PRISM III score is a good predictor of mortality and it is a good indicator of severity of illness on the day of admission.

Sri Lanka Journal of Child Health, 2018; 47(2): 118-124