Pediatric Index of Mortality 3 score as a predictor for the outcomes of critically ill patients

  • Gusti Ayu Nyoman Yulia Sitta Dewi KSM Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RSUP sanglah Denpasark
  • Dyah Kanya Wati KSM Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RSUP sanglah Denpasark
  • Made Gede Dwi Lingga Utama KSM Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RSUP sanglah Denpasark
  • Ketut Suarta Suarta
  • I Wayan Darma Artana KSM Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Udayana RSUP sanglah Denpasark
  • Made Sukmawati
Keywords: pediatric index mortality 3 scores; critically ill; prognosis outcomes; pediatric intensive care units


Background The ability to predict mortality in critically ill patients is important for assessing patient prognosis, evaluating therapy, and assessing intensive care unit quality. The Pediatric Index of Mortality (PIM) 3 is a scoring system to predict outcomes in order to assist clinical decision-making.
Objective To assess the ability of PIM 3 to predict outcomes of critically ill PICU patients.
Methods This prospective cohort study included 150 children aged 1 month to 18 years who were admitted to the pediatric intensive care unit (PICU), Sanglah Hospital, Denpasar, Bali. Subjects were grouped into two based on ROC curve PIM score ≥48 and <48. The PIM 3 score was consisted of 10 variables, with a re-diagnosis classification of the PIM 2 score. Bivariate analysis was conducted to both groups to find the distribution of mortality in both groups, followed by homogenity test on variables gender, age, nutritional status, lenght of stay and mechanical ventilation. Variables which made the cut on bivariate test were included in multivariate analysis.
Results The optimal PIM 3 score limit in predicting mortality was ≥48, with area under the curve (AUC) 76% (95%CI 0.69 to 0.85). Multivariate analysis revealed a 2.48 times increased risk to mortality in patients with PIM 3 score ≥48 (95%CI 1.6 to 3.7). In addition, PICU length of stay ≤7 days was a significant risk factor for mortality.
Conclusion The PIM 3 has a good ability to predict the outcome of critically ill PICU patients. Critically ill patients with PIM 3 score ≥48 have a higher risk of mortality compared to those with PIM 3 < 48.


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How to Cite
Dewi GAN, Wati D, Utama MG, Suarta K, Artana IW, Sukmawati M. Pediatric Index of Mortality 3 score as a predictor for the outcomes of critically ill patients. PI [Internet]. 13Nov.2020 [cited 22May2024];60(6):328-3. Available from:
Emergency & Pediatric Intensive Care
Received 2020-03-20
Accepted 2020-11-13
Published 2020-11-13