Çocuk yoğun bakım ünitesinde mortalite skorlama sistemlerinin güvenilirliği ve etkinliğinin karşılaştırılması

Year 2024, Volume: 17 Issue: 4, 664 - 673, 09.10.2024

Hatice Feray Arı , Salim Reşitoğlu , Mehmet Akif Tuncel , Mahmut Can Şerbetçi

https://doi.org/10.31362/patd.1479595

Abstract

Amaç: Çocuk yoğun bakım ünitesinde (ÇYBÜ) yüksek mortalite riski önemli bir sorundur. Mortalite riskinin
erken ön görülmesi için çeşitli risk skorlama sistemleri vardır. Pediatric Risk of Mortality (PRISM), Pediatric
Index of Mortality (PIM), Pediatric Logistic Organ Dysfunction (PELOD) ve Pediatric Sequential Organ Failure
Assessment (PSOFA) yaygın olarak kullanılmaktadır. Çalışmamızın amacı, PRISM III, PIM3, PELOD-2 ve
PSOFA’ nın mortaliteyi öngörmedeki gücünün ve etkinliğinin değerlendirilmesidir.
Gereç ve yöntem: Tek merkezli retrospektif çalışmada Nisan-Aralık 2021 tarihleri arasında ÇYBÜ'de yatan 1 ay-
18 yaş arası tüm hastalar incelendi. Elektronik kayıtlarından demografik özellikleri, klinik öyküleri ve morbidite/
mortalite durumu araştırıldı.
Bulgular: Çalışmaya ÇYBÜ yatış süresi 56,73±105,95 gün olan 300 hasta dahil edildi. Çalışma sonunda 56
(%18,7) hasta vefat etmişti. Tüm skorlama sistemleri ve mortalite korelasyonları istatistiksel olarak anlamlı
bulundu (p<0,0001). Mortaliteyi öngörmede başarı oranları, duyarlılık ve özgüllük açısından incelendiğinde
başarılı olma oranı sırasıyla PRISM III, PELOD-2, PSOFA ve PIM 3 idi.
Sonuç: Dört mortalite skorlama sistemini karşılaştıran herhangi bir çalışmanın bulunmaması, kritik hastalığı
olan çocuklarda erken tanı ve hızlı müdahale için skorlama sistemleri önemini artırmaktadır. Çalışmamıza
dayanarak, PRISM III verilerinin heterojen hasta popülasyonumuzda mortalite ön gördürme için daha güvenilir
olduğu bulunmuştur.

Keywords

Mortalite, pediatri, yoğun bakım, güvenilirlik, etkililik

Comparison between mortality scoring systems in pediatric intensive care unit reliability and effectiveness

Abstract

Purpose: In pediatric intensive care unit (PICU), high mortality risk is a significant issue. Risk adjustment tools
are in place for early estimation of mortality risk. Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality
(PIM), Pediatric Logistic Organ Dysfunction (PELOD) and Pediatric Sequential Organ Failure Assessment
(PSOFA) are commonly used. The aim of this study was to evaluate the predictive performance of mortality
using PRISM III, PIM3, PELOD-2, and PSOFA.
Materials and methods: This retrospective single-center study analysed patients aged between 1 month-18
years who were treated in PICU for various diseases between April and December 2021. Their electronic
records were retrospectively examined for demographic characteristics, medical and clinical expectations, and
morbidity/mortality.
Results: The study included 300 patients with a hospitalization period of 56.73±105.95 days. At the end of the
study, 56 (18.7%) patients had died. All scoring systems and mortality correlations were statistically significant
(p<0.0001). The predictive success rates for mortality, ranked from best to worst, were PRISM III, PELOD-2,
PSOFA, and PIM 3, respectively, in terms of sensitivity and specificity.
Conclusion: The absence of any studies comparing these four mortality scoring systems adds to their
importance for early recognition and rapid intervention in critically ill children. Based on our study, PRISM III
data has been found to be more reliable in this heterogeneous population.

Keywords

Mortality, pediatric, intensive care, reliability, effectiveness

Ethical Statement

Ethics: The ethics committee approval for the study was obtained Harran University Clinical Research Ethics Committee (22/01/12).

Supporting Institution

yok

Thanks

Acknowledgments: The authors express gratitude to the pediatric intensive care team who participated in the treatment and follow-up of the patients included in the study.

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