Based on the concept that outcome prediction scores might not work properly in a setting where patient characteristics or diagnoses are substantially different from those of patients used in the development of the score,4 and the observation of the increased prevalence of children admitted to the PICU with CCCs in recent years, who had higher mortality rates than patients without CCCs,2 it was considered important to evaluate the performance of outcome prediction scores in a setting that would reflect these changes. The aim of this study was to evaluate the performance
of the PIM2 score for predicting outcomes in a PICU with high prevalence of patients selleck with CCCs, and to compare the score performance
between patients with and without CCCs. This study was approved by the Research Ethics Committee of Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, and an informed consent was obtained for all participants. A prospective cohort study was conductions in the PICU of the Hospital das Clínicas. The PICU has ten beds, with approximately 370 admissions per year, both clinical and surgical, including cardiac surgery. All patients admitted to the PICU between February 1, 2009 and January 31, 2011 were included in the study. Patients younger than 30 days or older than 18 years, patients who died within the first two hours of admission, patients with suspected brain death at admission that was later confirmed, patients considered as having Raf inhibitor no chance of curative treatment (NCCT), and patients see more whose parents/guardians did not sign the consent form were excluded from the study. The study variables were those used to characterize the patients, death probability calculated by PIM2, and outcome variables. The data from the analyzed variables were collected
by the researchers from the medical and nursing records. For patient characterization, the following data were evaluated: age, gender, presence of CCC, type of CCC, type of admission (medical or surgical), type of clinical pathology, type of surgical pathology, elective or non-elective admission condition, and use of invasive mechanical ventilation. The presence of CCC was recorded when the patient had any medical condition characterized by pathology duration of at least 12 months (except when the patient died) that affected any body system or organ severely enough to require care from a pediatric specialty, and probably requiring hospitalization in a tertiary hospital.1 The patient’s CCC was classified according to the classification developed by Feudtner et al.:1 neuromuscular malformations; cardiovascular malformations; respiratory, renal, gastrointestinal, hematological or immunological, and metabolic; other genetic or congenital defects; and neoplasms.