Evaluation of the Paediatric Index of Mortality in children managed on adult intensive care units.

Abstract

To evaluate the performance of the Paediatric Index of Mortality (PIM) in children cared for in adult intensive care units (ICUs) in district general hospitals in the South West Region of England. An observational survey of all children admitted to adult ICUs in 15 district general hospitals between November 2000 and August 2002. For comparison, data were also collected from the regional paediatric ICUs between November 2000 and March 2002. Data were collected from 374 children admitted to adult ICUs and 850 children admitted to the regional paediatric ICU. There were significant differences in the patient characteristics between the two groups. In the adult ICU paediatric population, PIM discriminated well between death and survival (Az ROC = 0.96 (95% confidence interval, 0.93 to 0.99)) and calibrated well across deciles of risk (goodness of fit chi2 = 4.55 (8 df), p = 0.8). PIM performs well as a risk adjustment method in children whose entire care remains in the adult ICU of a district general hospital. This is important should the Paediatric Intensive Care Audit Network (PICAnet) decide to extend its data collection beyond paediatric intensive care units to other units caring for critically ill children.