Pediatric index of mortality 2 scores in pediatric intensive care unit patients

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Monica Sampurna
Ida Bagus Suparyatha
I Gede Raka Widiana


Background Comprehensive care for critically ill children in the pediatric intensive care unit (PICU) is done with the aim of achieving good outcomes. Severe disease in children is characterized by disruption of homeostatic processes, and can be evaluated by mortality scoring methods. There are several mortality scoring methods which can be used to predict mortality in children, the pediatric risk of mortality (PRISM) and pediatric index of mortality (PIM) are the most preferably used among all. The pediatric index of mortality 2(PIM2) is a key mortality prediction model for children receiving treatment in intensive care units, but its use has not been well validated in Indonesia.
Objective To evaluate the performance of PIM2 model in PICU patients.
Methods This cross-sectional study was conducted on PICU patients at Sanglah Hospital from November 2012 to April 2013. Patients underwent PIM2 scoring during their admission. The predictive ability of PIM2 scoring for patient mortality was analyzed using ROC curve.
Results A total of 54 patients were included in this study, of whom 8 (14.8%) died. Discrimination between survival and death was assessed by the area under the receiver operating characteristic curve and found to be 0.81 (95% CI 0.59 to 1.03). Sensitivity was 75 (95%CI 36 to 96)% and specificity was 98 (95%CI 87 to 99)%. The PIM2 cut off value was ≥ -0.99.
Conclusion The PIM 2 model has a good discriminatory power and calibration for predicting the mortality of children admitted to PICU and therefore is recommended for routine use in clinical practice. [

Article Details

How to Cite
Sampurna M, Suparyatha I, Widiana IG. Pediatric index of mortality 2 scores in pediatric intensive care unit patients. PI [Internet]. 12May2016 [cited 16Sep.2019];56(1):43-. Available from:
Emergency & Pediatric Intensive Care
Author Biography

Monica Sampurna, Departments of Child Health, Udayana University Medical School/Sanglah Hospital, Denpasar, Bali, Indonesia




Received 2016-04-01
Published 2016-05-12


1. Shann F, Pearson G, Slater A, Wilkinson K. Pediatric index of mortality (PIM): a mortality prediction model for children in intensive care. Intensive Care Med. 1997;23:201-7.
2. Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score. Crit Care Med. 1988;16:1110-6.
3. Slater A, Shann F, Pearson G, Paediatric Index of Mortality (PIM) Study Group. PIM2: a revised version of the pediatric index of mortality. Intensive Care Med. 2003;29:278-85.
4. Pollack MM, Patel KM, Ruttiman UE. PRISM III: an updated Pediatric Risk of Mortality score. Crit Care Med. 1996;24:743-52.
5. Slater A, Shann F, ANZICS Paediatric Study Group. The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatr Crit Care Med. 2004;5:447-54.
6. Martha VF, Garcia PC, Piva JP, Einloft PR, Bruno F, Rampon V. Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit. J Pediatr (Rio J). 2005;81:259-64.
7. Taori RN, Lahiri KR, Tullu MS. Performance of PRISM (Pediatric Risk of Mortality) score and PIM (Pediatric Index of Mortality) score in a tertiary care pediatricICU. Indian J Pediatr. 2010;77:267-71.
8. Lemeshow S, Hosmer JDW, Klar J, Lwanga SK. Adequacy of sample size in health studies. Geneva: World Health Organization; 1991. p.1-2.
9. Arslankoylu AE, Bayrakci B, Oymak Y. Admission time and mortality rates. Indian J Pediatr. 2008;75:691-4.
10. Salamati P, Talaee S, Eghbalkhah A, Chaman R, Mokhtari Z, Azarshahin M. Validation of pediatric index of mortality-2 scoring systemin a single pediatric intensive care unit in Iran. Iran J Pediatr. 2012;22:481-6.
11. Ciofi degli Atti ML, Cuttini M, Rava L, Rinaldi S, Brusco C, Cogo P, et al. Performance of te pediatric index of mortality 2 (PIM-2) in cardiac and mixedintensive care units in a tertiary children’s referral hospital in Italy. BMC Pediatr. 2013;13:100-8.
12. Choi KM, Ng DK, Wong SF, Kwok KL, Chow PY, Chan CH, et al. Assessment of the Pediatric Index of Mortality (PIM) and the Pediatric Risk of Mortality (PRISM) III score for prediction of mortality in a paediatric intensive care unit in Hong Kong. Hong Kong Med J. 2005;11:97-103.
13. Imamura T, Nakagawa S, Goldman RD, Fujiwara T. Validation of pediatric index of mortality 2 (PIM2)in a single pediatric intensive care unit in Japan. Intensive Care Med. 2012;38:649-54.
14. Pearson GA, Stickley J, Shann F. Calibration of the paediatric index of mortality in UK paediatric intensive care units. Arch Dis Child. 2001;84:125-8.
15. Dahlan MS. Analisis penelitian diagnostik. In: Seri evidence-based medicine 5: penelitian diagnostik. 1st ed. Jakarta: Salemba Medika; 2009. p.19-30.
16. Brady AR, Harrison D, Black S, Jones S, Rowan K, Pearson G, et al. Assessment and optimization of mortality prediction tools for admissions to pediatric intensive care in United Kingdom. Pediatrics. 2006;117:733-42.