The Performance of Modified Pediatric Index of Mortality-2 Scoring System in a Pediatric Intensive Care Unit in Ethiopia
Background: The mortality rate remains high in pediatrics intensive care units. Hence, predicting mortality in a pediatric intensive care unit (PICU) is vital for improving the quality of care and survival of children. The pediatric index of mortality-2 (PIM-2), is one of the most used prediction models in resource-limited setups, which does not need extensive laboratory investigation. Thus, this study aimed at assessing the performance of the modified PIM-2 score in a pediatric intensive care unit at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.
Method: A single-centered prospective cohort study was conducted among 313 children admitted to the pediatrics intensive care unit at the University of Gondar Comprehensive Specialized Hospital. Data were collected by structured checklists adapted from different pieces of literature, through history taking, patient document review, and physical examination. The modified PIM-2 was scored within the first hour of admission. The standardized mortality ratio (SMR) was calculated using the Mid-P exact method. The discriminatory function was assessed by the area under the receiver operating characteristic (ROC) curve. The Hosmer-Lemeshow goodness of fit test was used for calibration.
Result: A total of 313 participants with a median age of 48 months (IQR: 12–122) at admission were included in this analysis. Of those 59.7% were males. The median duration of hospital stay was three days (IQR: 1–6).A total of 102 (32.6%) children died during the study period. The overall predicted mortality rate by the PIM-2 score was 11.1%, giving an SMR of 2.93 (95% CI: 2.11, 3.95). The area under receiver operating characteristics (AUROC) of PIM-2 was 0.79 (95% CI: 0.76, 0.86), and the Hosmer-Lemeshow goodness of fit test across deciles of risk strata showed good calibration (X2=7.45, df=8, p=0.489) as well as across subgroups by age, diagnosis, and nutritional status.
Conclusion: The modified PIM-2 had a fair discriminatory function and good calibration in the study setting. Though it can be used to prioritize care and for the assessment of the quality of care, we recommend developing and validating another parsimonious risk score with a better discriminatory function.
Keywords
Authors
How to Cite
Download Citation
License
Copyright © 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Similar Articles
- Osman Abdie , Ashenafi Tazebew, Zeleke Mekonnen, Short-Term Outcome of Convulsive Status Epilepticus in Hospital Admitted Children: Etiology and Clinical Feature in North-West Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 12 No. 2 (2022)
- Yigzaw Kebede, Gashaw Andarge, Tesfahun Melesse, Temesgen Azmeraw, Takele Tadesse, Yiforkir Tefera, Abebaw Gebeyehu, Tadesse Awoke, Kassahun Alemu, Sisay Yifru, Afework Kassu, Tefera Abula, Mengesha Admassu, Shitaye Alemu, Solomon Meseret, Digsu Negesse, Getu Degu, Solomon Mekonnen, Berihun Megabiaw, Wondwosen Zemene, Assefa Getachew, Belaynew Wassie, Solomon Amsalu, Mamo Wubshet, Mezgebu Yitayal, Fasil Tessema, Yihunie Lakew, Tariku Dejene, Ejigu Gebeye, Melkamu Birku, Yosef Fekadu, Population Dynamics in Dabat Health and Demographic Surveillance System Sites, Dabat District, Northwest Ethiopia: A Four-year Surveillance Report (2009 To 2012) , Ethiopian Journal of Health and Biomedical Sciences: Vol. 7 No. 1 (2015)
- Bahiru Tenaw, Abebe Muche, Engidaw Fentahun , Abyot Endale , An Evaluation of Acute and Sub-Acute Toxicity of Methanolic Root Extract Of Myricasalicifolia A. Rich (Myricaceae) On the Histopathology of the Liver, the Kidney and Some Blood Parameters in Swiss Albino Mice , Ethiopian Journal of Health and Biomedical Sciences: Vol. 9 No. 1 (2019)
- Wubet Birhan Yigzaw, Belay Tessema, Shu-Hua Wang , Jordi B. Torrelles , Accuracy on Diagnostic Performance of Point Of Care Liodetect® Tb-St Rapid Test for the Diagnosis of Pulmonary Tuberculosis in North West Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 11 No. 1 (2021)
- Bethelhem Anteneh, Biniam Kefyalew, Tezera Tadele, Binyam Tilahun, Alemayehu Teklu, Zeleke Mekonnen, The role of Community Engagement on Compassionate, Respectful and Caring health service: Perceived effectiveness among health staff in the health system of Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 12 No. 1 (2022)
- Kumlachew Mergiaw, Habtemaryam Tedla, Awraris Hailu, Zenebe Abebe, Zenawi Hagos, Duration-to-Attain Target Blood Pressure Level and Its Predictors among Newly Diagnosed Hypertensive Adults Treated in a Comprehensive Hospital in Central Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 16 No. 1 (2026)
- Zeamanuel Anteneh, Getu Debalkie, Mehari Woldemariam, Aklilu Endalamaw, Asmamaw Atnafu, Magnitude of disclosure and associated factors among HIV positive children in North West Ethiopia, A mixed-method , Ethiopian Journal of Health and Biomedical Sciences: Vol. 12 No. 2 (2022)
- Aschalew Gelaw, Detection of Rotarix Vaccine Viruses in Older Children with Acute Gastroenteritis, Northwest Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 11 No. 1 (2021)
- Afework Kassu, Masayuki Fujino, Masako Nishizawa, Getahun Mengistu, Ermias Diro, Belete Ayele, Dereje Ketema, Feleke Moges, Andargachew Mulu, Gizachew Yismaw, Kahsay Huruy, Ebba Abate, Assefa Getachew, Moges Tiruneh, Yared Wondmikun, Wataru Sugiura, Fusao Ota, Levels of serum HIV-1 RNA viral load in tuberculosis patients with or without intestinal parasites during treatment of tuberculosis in Gondar, Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 1 No. 1 (2008)
- Feven Abera Mamo, Gelana Garoma Ararso, Demerew Dejene Dana, Oral Cancer Awareness among Patients Visiting Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia , Ethiopian Journal of Health and Biomedical Sciences: Vol. 15 No. 2 (2025)
You may also start an advanced similarity search for this article.