Evidence map›Paper›PMID 26492059›Full record

ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2016

The Pediatric Risk of Mortality Score: Update 2015.

Murray M Pollack, Richard Holubkov, Tomohiko Funai, J Michael Dean, John T Berger, David L Wessel, Kathleen Meert, Robert A Berg, Christopher J L Newth, Rick E Harrison and 6 more

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In one paragraph

Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 140 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
140citing papers in PubMed, 1 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

140 citing papers in PubMed, 1 synthesis or guideline pooled it, 257 citations in OpenAlex.

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  5. Examining 1:1 vs. 4:1 Packed Red Blood Cell to Fresh Frozen Plasma Ratio Transfusion During Pediatric Burn Excision.Journal of burn care & research : official publication of the American Burn Association · 2020
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80 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 8 institutions in 1 country.

Murray M Pollack1Department of Pediatrics, Children's National Medical Center and the George Washington University School of Medicine and Health Sciences, Washington DC. 2Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT. 3Department of Pediatrics, Children's National Medical Center, Washington DC. 4Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI. 5Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA. 6Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA. 7Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA. 8Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA. 9Department of Child Health, Phoenix Children's Hospital and University of Arizona College of Medicine-Phoenix, Phoenix, AZ. 10Department of Pediatrics, University of Michigan, Ann Arbor, MI. 11Pediatric Trauma and Critical Illness Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institutes of Health (NIH), Bethesda, MD.
Richard Holubkov
Tomohiko Funai
J Michael Dean
John T Berger
David L Wessel
Kathleen Meert
Robert A Berg
Christopher J L Newth
Rick E Harrison
Joseph Carcillo
Heidi Dalton
Thomas Shanley
Tammara L Jenkins
Robert Tamburro
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
University of Utah · USChildren's Hospital of Los Angeles · USCritical Illness & Trauma Foundation · USChildren's Hospital of Michigan · USChildren's Hospital of Philadelphia · USChildren's Hospital of Pittsburgh · USUniversity of California, Los Angeles · USUniversity of Michigan–Ann Arbor · US

Funding

Data Coordinating Center for the Collaborative Pediatric Critical Care Research NetworkU01HD049934 · NICHD · UNIVERSITY OF UTAH · PI DEAN, JONATHAN MICHAEL · 2005 to 2020
$35.2M
Physiologically Guided Ventilator Strategies in ChildrenU10HD050012 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI NEWTH, CHRISTOPHER JOHN · 2005 to 2014
$3.7M
Neurodevelopmental Outcome after Cardiac Intensive CareU10HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI WESSEL, DAVID LLOYD · 2005 to 2014
$3.7M
Collaborative Pediatric Critical Care Research NetworkU10HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2005 to 2014
$3.2M
Metoclopramide prevents PICU nosocomial infectionU10HD049983 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARCILLO, JOSEPH A · 2005 to 2014
$3.1M
Collaborative Pediatric Critical Care Research Network (CPCCRN) at Children's NationalUG1HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI POLLACK, MURRAY MICHAEL, WESSEL, DAVID LLOYD · 2015 to 2020
$1.8M
Pediatric Critical Care Research Network at Children's Hospital of PhiladelphiaUG1HD063108 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN, ZUPPA, ATHENA F. · 2015 to 2020
$1.7M
Collaborative Pediatric Critical Care Research NetworkUG1HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2015 to 2020
$1.6M
Pediatric Critical Care Research Network at Children's Hospital of PhiladelphiaU10HD063108 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN · 2010 to 2014
$1.4M
Predicting Morbidity from Pediatric Critical CareU10HD063114 · NICHD · PHOENIX CHILDREN'S HOSPITAL · PI DALTON, HEIDI J, LUND, DENNIS P · 2010 to 2014
$1.4M
Collaborative Pediatric Research Critical Care Network(U10)U10HD063106 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SHANLEY, THOMAS P. · 2010 to 2014
$1.3M
Collaborative Pediatric Critical Care Research Network - Clinical SiteRL1HD107773 · NICHD · CENTRAL MICHIGAN UNIVERSITY · PI KATHLEEN L. MEERT · 2021 to 2026
$862k
NICHD NIH HHS RL1 HD107773NICHD NIH HHS U01 HD049934NICHD NIH HHS U01HD049934NICHD NIH HHS U10 HD049981NICHD NIH HHS U10HD049981NICHD NIH HHS U10 HD049983NICHD NIH HHS U10HD049983NICHD NIH HHS U10 HD050012NICHD NIH HHS U10HD050012NICHD NIH HHS U10 HD050096NICHD NIH HHS U10HD050096NICHD NIH HHS U10 HD063106NICHD NIH HHS U10HD063106NICHD NIH HHS U10 HD063108NICHD NIH HHS U10HD063108NICHD NIH HHS U10 HD063114NICHD NIH HHS U10HD063114NICHD NIH HHS UG1 HD049981NICHD NIH HHS UG1 HD050012NICHD NIH HHS UG1 HD050096NICHD NIH HHS UG1 HD063106NICHD NIH HHS UG1 HD063108
6 · The paper itself

Abstract

objectivesSeverity of illness measures have long been used in pediatric critical care. The Pediatric Risk of Mortality is a physiologically based score used to quantify physiologic status, and when combined with other independent variables, it can compute expected mortality risk and expected morbidity risk. Although the physiologic ranges for the Pediatric Risk of Mortality variables have not changed, recent Pediatric Risk of Mortality data collection improvements have been made to adapt to new practice patterns, minimize bias, and reduce potential sources of error. These include changing the outcome to hospital survival/death for the first PICU admission only, shortening the data collection period and altering the Pediatric Risk of Mortality data collection period for patients admitted for "optimizing" care before cardiac surgery or interventional catheterization. This analysis incorporates those changes, assesses the potential for Pediatric Risk of Mortality physiologic variable subcategories to improve score performance, and recalibrates the Pediatric Risk of Mortality score, placing the algorithms (Pediatric Risk of Mortality IV) in the public domain.

designProspective cohort study from December 4, 2011, to April 7, 2013. MEASUREMENTS AND MAIN

resultsAmong 10,078 admissions, the unadjusted mortality rate was 2.7% (site range, 1.3-5.0%). Data were divided into derivation (75%) and validation (25%) sets. The new Pediatric Risk of Mortality prediction algorithm (Pediatric Risk of Mortality IV) includes the same Pediatric Risk of Mortality physiologic variable ranges with the subcategories of neurologic and nonneurologic Pediatric Risk of Mortality scores, age, admission source, cardiopulmonary arrest within 24 hours before admission, cancer, and low-risk systems of primary dysfunction. The area under the receiver operating characteristic curve for the development and validation sets was 0.88 ± 0.013 and 0.90 ± 0.018, respectively. The Hosmer-Lemeshow goodness of fit statistics indicated adequate model fit for both the development (p = 0.39) and validation (p = 0.50) sets.

conclusionsThe new Pediatric Risk of Mortality data collection methods include significant improvements that minimize the potential for bias and errors, and the new Pediatric Risk of Mortality IV algorithm for survival and death has excellent prediction performance.

Indexed as

Severity of Illness IndexAge FactorsAlgorithmsChild, PreschoolHospital MortalityHumansInfantInfant, NewbornIntensive Care Units, PediatricProspective StudiesReproducibility of ResultsRisk AssessmentROC Curve

Identifiers

PMID26492059
PMCPMC5048467
OpenAlexW1863824507

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.