A Novel Scoring System for Pediatric Intensive Care Unit Patients: Modified APACHE II and Comparison with Other Scoring Systems

Objective: Several scoring systems are being used in order to objectively evaluate the clinical conditions and the prognosis of the patients who are hospitalized in the intensive care units and to be able to use the intensive care units efficiently. The aim of this study is to investigate the availability and reliability of Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality (PIM) scores in determining mortality in the patients who were monitored in our pediatric intensive care unit during one year and to compare APACHE II (Acute Physiological and Chronic Health Evaluation Score II) scoring system modified for pediatric age group with these scoring systems. Material and Methods: This study was performed on 250 patients aged between 1 month- 16 years who were monitored in the pediatric intensive care unit for a period of one year. The ability of PRISM, PIM and APACHE II scoring systems on determining potantial mortality risk was evaluated in three different age groups (1-12 months, 13-60 months and above 61 months). Results: In our study, the mortality rate was found as 34.4% while the average expected risk of death was found to be 16.6% in PIM scoring system, 21.5% in PRISM and 37.6% in modified APACHE. When assessed these three mortality scoring systems, the modified APACHE II scoring system was the most successful in theprediction of death rates of all three age groups in terms of the expected average mortality risk, SMR and the results of ROC analysis. Conlusion: We suggest that a new and more efficient scoring system can be composed by planning multicentered studies including pediatric intensive care units with different features