Yashwanth Raj, T (2017) Prediction of Outcome of the Children admitted in Pediatric Intensive Care Unit using Prism III Scoring System. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: The field of Pediatrics has shown a lot of advancements and improvements in the recent past, which is definitely essential, as we pediatricians care for the young, tender, budding and yet to bloom part of the society. Pediatrics has been considered as one of the most sensitive fields of medicine and with the growing burden of illness among children, it has become a huge responsibility as a lot has to be shouldered by the Pediatric physician. This is aptly applicable especially for the Pediatric Intensivist who deals with children who are critically ill and at the verge of mortality many a times. To deal with children who are critically ill is a matter of high complexity. Hence they are catered in Pediatric Intensive Care Units designed especially for intensive monitoring of these children. These Pediatric Intensive Care Units have to be highly sophisticated with the latest technological advancements to treat these children, which costs a lot. OBJECTIVE: The aim of the study was to analyze the ability of PRISM III score in predicting the outcome of children admitted in PICU METHODS: A prospective descriptive study was done between August 2015 and July 2016 in the PICU of Institute of Child Health and Hospital for Children using PRISM III scoring to predict their outcome using their physiological parameters, blood gas analysis, biochemical and pathological lab parameters. RESULTS: A total of 100 children (64 boys and 36 girls) admitted in PICU comprised the study group. 47% were infant population. Respiratory system was the predominantly affected one (41%) followed by CNS (36%). About 42% of the study population was found to have wasting yet nutritional status did not contribute to the outcome. 89% of children had required mechanical ventilation and was considered to be an important risk factor, determining the outcome. Treatment with vasoactive agents contributed significantly in deciding the outcome. The chances for mortality increased with the addition of an inotrope. Need for renal replacement therapy & Cardio-pulmonary resuscitation contributed significantly to the outcome. MODS did not have a significant impact on outcome. For an increase of 5 in the PRISM score, a child’s odds of death increased by 13%. CONCLUSION: PRISM III score in our study showed adequate discriminatory capacity and calibration & can be considered a good tool for assessing the outcome of Paediatric patients admitted in the PICU. Variables considered to have a significant effect on the outcome were PRISM III score, Mechanical ventilation, Usage of vaso-active agents, renal replacement therapy and need for cardio-pulmonary resuscitation.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201417017 |
| Uncontrolled Keywords: | Prediction, Outcome, Children, Pediatric Intensive Care Unit, Prism III Scoring System. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 23 Jul 2020 16:13 |
| Last Modified: | 23 Jul 2020 16:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12663 |
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