Evidence map›Paper›PMID 29923941›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 Societies2018

Intensive Care Mortality Prognostic Model for Pediatric Pulmonary Hypertension.

Emily Morell Balkin, Matt S Zinter, Satish K Rajagopal, Roberta L Keller, Jeffrey R Fineman, Martina A Steurer

Open access · greenAbstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
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, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 30% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Narrowing the gap: expected versus deployment performance.Journal of the American Medical Informatics Association : JAMIA · 2023
    Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Emily Morell BalkinDivision of Pediatric Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
Matt S ZinterDivision of Pediatric Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
Satish K RajagopalDivision of Pediatric Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
Roberta L KellerDivision of Neonatology, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
Jeffrey R FinemanDivision of Pediatric Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
Martina A SteurerDivision of Pediatric Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, CA.
University of California, San Francisco · US

Funding

Pediatric Scientist Development Program (PSDP) [K12]K12HD000850 · NICHD · YALE UNIVERSITY · PI Sallie R. Permar · 1987 to 2026
$44.1M
PERINATAL PULMONARY HYPERTENSION: DEVELOPMENT MEDIATORSR01HL061284 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FINEMAN, JEFFREY R · 1999 to 2016
$8.3M
Research Training in Pediatric Critical Care MedicineT32HD049303 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JEFFREY R FINEMAN · 2006 to 2026
$3.1M
Perinatal NO signaling in congenital heart diseaseR01HL137282 · NHLBI · UNIVERSITY OF ARIZONA · PI BLACK, STEPHEN M, FINEMAN, JEFFREY R · 2017 to 2020
$2.7M
UCSF Clinical Research Center for Prematurity and Respiratory Outcomes ProgramU01HL101798 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BALLARD, PHILIP L., KELLER, ROBERTA L · 2010 to 2014
$2.1M
Chronic Sildenafil for Severe Diaphragmatic HerniaK23HL079922 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KELLER, ROBERTA L · 2005 to 2009
$602k
NHLBI NIH HHS K23 HL079922NHLBI NIH HHS L40 HL138866NHLBI NIH HHS R01 HL061284NHLBI NIH HHS R01 HL137282NHLBI NIH HHS U01 HL101798NICHD NIH HHS K12 HD000850NICHD NIH HHS T32 HD049303
6 · The paper itself

Abstract

objectivesThe disease burden and mortality of children with pulmonary hypertension are significantly higher than for the general PICU population. We aimed to develop a risk-adjustment tool predicting PICU mortality for pediatric pulmonary hypertension patients: the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score.

designRetrospective analysis of prospectively collected multicenter pediatric critical care data.

settingOne-hundred forty-three centers submitting data to Virtual Pediatric Systems database between January 1, 2009, and December 31, 2015. PATIENTS: Patients 21 years old or younger with a diagnosis of pulmonary hypertension.

interventionsTwenty-one demographic, diagnostic, and physiologic variables obtained within 12 hours of PICU admission were assessed for inclusion. Multivariable logistic regression with stepwise selection was performed to develop the final model. Receiver operating characteristic curves were used to compare the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score with Pediatric Risk of Mortality 3 and Pediatric Index of Mortality 2 scores. MEASUREMENTS AND MAIN

resultsFourteen-thousand two-hundred sixty-eight admissions with a diagnosis of pulmonary hypertension were included. Primary outcome was PICU mortality. Fourteen variables were selected for the final model: age, bradycardia, systolic hypotension, tachypnea, pH, FIO2, hemoglobin, blood urea nitrogen, creatinine, mechanical ventilation, nonelective admission, previous PICU admission, PICU admission due to nonsurgical cardiovascular disease, and cardiac arrest immediately prior to admission. The receiver operating characteristic curve for the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality model (area under the curve = 0.77) performed significantly better than the receiver operating characteristic curves for Pediatric Risk of Mortality 3 (area under the curve = 0.71; p < 0.001) and Pediatric Index of Mortality 2 (area under the curve = 0.69; p < 0.001), respectively.

conclusionsThe Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score is a parsimonious model that performs better than Pediatric Risk of Mortality 3 and Pediatric Index of Mortality 2 for mortality in a multicenter cohort of pediatric pulmonary hypertension patients admitted to PICUs. Application of the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality model to pulmonary hypertension patients in the PICU might facilitate earlier identification of patients at high risk for mortality and improve the ability to prognosticate for patients and families.

Indexed as

Hospital MortalitySeverity of Illness IndexAdolescentChild, PreschoolDatabases, FactualFemaleHumansHypertension, PulmonaryInfantInfant, NewbornIntensive Care Units, PediatricLogistic ModelsMaleRetrospective StudiesRisk AdjustmentROC Curve

Identifiers

PMID29923941
PMCPMC6086734
OpenAlexW2809525429

What OpenQuestion holds

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Registered trials

None linked

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.