Are the pediatric index of mortality 2 and 3 equal predictors of mortality? an intensive care unit-based concordance study
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Fecha
2020-05-25Autor(es)
Patino-Hernández, DanielaQuiñonez López, Alba Deyanira
Zuluaga, César Augusto
García Peña, Ángel Alberto
Muñoz-Velandia, Oscar Mauricio
Autor(es) Corporativo(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Cardiología
Tipo
Artículo de revista
ISSN
0103-507X / 1982-4335 (Electrónico)
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Título alternativo
Pediatric Index of Mortality 2 e 3 são preditores de mortalidade iguais? Estudo de concordância com base em unidade de terapia intensivaAbstract
Objective: To determine the
concordance of mortality risk classification
through the use of the Pediatric Index of
Mortality (PIM) 2 and 3.
Methods: Through a retrospective
cohort, we evaluated patients admitted to
the pediatric intensive care unit between
April 2016 and December 2018. We
calculated the mortality risk with the
PIM 2 and 3. Analyses were carried out
to determine the concordance between
the risk classification obtained with both
scales using unweighted and linearly
weighted kappa.
Results: A total of 722 subjects were
included, and 66.6% had a chronic
condition. The overall mortality was
3.7%. The global kappa concordance
coefficient for classifying patients
according to risk with the PIM 2 and 3 was
moderate at 0.48 (95%CI 0.43 - 0.53).
After linear weighting, concordance was
substantial at 0.64 (95%CI 0.59 - 0.69).
For cardiac surgery patients, concordance
for risk classification was fair at 0.30
(95%CI 0.21 - 0.39), and after linear
weighting, concordance was only
moderate at 0.49 (95%CI 0.39 - 0.59).
The PIM 3 assigned a lower risk than
the PIM 2 in 44.8% of patients in this
subgroup.
Conclusion: Our study proves
that the PIM 2 and 3 are not clinically
equivalent and should not be used
interchangeably for quality evaluation
across pediatric intensive care units.
Validation studies must be performed
before using the PIM 2 or PIM 3 in
specific settings.
Keywords
Pediatric index of mortalityMortality
Infant
Newborn
Cardiac surgery
Intensive care units
Pediatric
Enlace al recurso
https://pubmed.ncbi.nlm.nih.gov/33470360/Fuente
Revista Brasileira de Terapia Intensiva; Volumen 32 Número 4 , Páginas 578 - 584 (2020)
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