Aplicação do Peadiatric Index of Mortality 2 em unidade de terapia intensiva pediátrica no Brasil

Abstract

Introduction: Paediatric Index of Mortality 2 (PIM2) is a major predictor of outcome scores used in the pediatric intensive care. Differences mixtures of cases compared with the development of the population can result in a performance score inappropriate model when applied in a new environment. It is recommended to evaluate the model in new scenarios to verify the persistence of performance scores. Objective: to evaluate the performance of PIM2 score in a Pediatric Intensive Care Unit (PICU) in Brazil. Methodology: a cohort study of 677 patients admitted to the pediatric ICU between February 1, 2009 and January 31, 2011, evaluating the performance of the score through discrimination and calibration. Results: the main characteristics of the study population were the high number of admissions after surgical procedures and the high prevalence of patients with complex chronic conditions and cancer. PIM2 showed adequate discrimination indicated by the area under the Receiver Operating Characteristic (ROC) of 0.84 (95%CI 0.810 to 0867) and inadequate calibration indicated by the Hosmer-Lemeshow test showed that a chi-square 43,4056 (p <0.0001). Conclusion: PIM2 showed poor performance in the study sample due to poor calibration. The mixture of cases can be one of the factors responsible for poor calibration, but the influence of the quality of care offered cannot be ruled out.