International Journal of Tropical Medicine
ISSN: Online 1818-779XISSN: Print 1816-3319
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Abstract
Critically ill children admitted to Pediatric Intensive Care Units (PICUs) are at increased risk of mortality. Prognostic scoring systems like the Pediatric Risk of Mortality (PRISM) III score help quantify illness severity and predict outcomes. While validated extensively in developed countries, data on its applicability in resource‐limited settings like India remain limited. This study evaluates the utility of PRISM III as a prognostic tool in a tertiary care PICU in Haldwani. This prospective observational study was conducted from September 2022 to February 2024 at the Department of Pediatrics, Government Medical College, Haldwani. A total of 260 pediatric patients admitted to the PICU for various critical conditions were included, with exclusions for neonates, surgical cases, and patients with burns or short PICU stays. PRISM III scores, based on 17 clinical and laboratory parameters within the first 24 hours of admission, were analyzed. Statistical analyses included ROC curve evaluation and chi‐square tests to correlate PRISM III scores with outcomes such as mortality, mechanical ventilation and vasoactive drug use. The study reported a mortality rate of 15% among participants, with higher PRISM III scores significantly associated with increased intervention requirements and mortality. Patients requiring mechanical ventilation and vasoactive drugs had mean scores of 15.01 and 16.89, respectively (p<0.01). The optimal PRISM III cut‐off score for predicting mortality was 12, with a sensitivity of 95%, specificity of 87% and overall accuracy of 91%. ROC analysis yielded an area under the curve (AUC) of 0.905. Higher PRISM III scores were inversely correlated with PICU and hospital stays, reflecting the critical nature of these cases. The PRISM III scoring system is an effective prognostic tool for critically ill pediatric patients in resource‐limited settings. It demonstrated strong predictive accuracy for mortality and highlighted its utility in assessing illness severity, guiding interventions and improving outcomes in PICU care. These findings support its broader application for optimizing critical care management in developing healthcare systems.
How to cite this article:
Gaurav Jangpangi, Ritu Rakholia and Prerna Chamoli. Study of Prism III Scoring System in the Outcome of Patient Admitted in Pediatric Intensive Care Unit in Tertiary Care Centre in Haldwani.
DOI: https://doi.org/10.36478/10.36478/makijtm.2025.1.30.34
URL: https://www.makhillpublications.co/view-article/1816-3319/10.36478/makijtm.2025.1.30.34