Document Type : original article

Authors

1 Student research committee, Mashhad University of Medical Sciences, Mashhad, Iran

2 -Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. -Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of community medicine and public health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of pediatrics, Mashhad university of medical sciences,mahshhad,iran

Abstract

Background: The main goal of the pediatric intensive care unit (PICU) is to reduce mortality. PRISM is one of the predictor models of mortality in patients admitted to the PICU. This study aimed to evaluate the effect of thrombocytopenia on the predicted death rate (PDR) in pediatrics admitted to the PICU, by the PRISM scoring system.
Methods: This cross-sectional study was performed on patients admitted to the PICU of Akbar Hospital, Mashhad, Iran, from March 2019 to March 2020. Based on the information collected during the first 4 h of patient admission to the PICU, the PRISM score was calculated by the PRISM online calculator. The percentage of PDR calculated for each patient indicated the possibility of patient mortality. Statistical analysis was carried out using SPSS software (Version 25, SPSS Inc., Chicago, IL, USA) at the significant level of α=0.05.
Results: The results of the data analysis demonstrated that along with increasing the severity of thrombocytopenia, an increase in the average PDR was observed. Furthermore, the findings revealed a significant correlation between the average PDR and the death of patients.
Conclusions: It can be concluded that the effect of thrombocytopenia on mortality is greater than that considered in the PRISM scoring system.

Keywords

  1. Taori RN, LaFhiri KR, Tullu MS. Performance of PRISM (Pediatric Risk of Mortality) score and PIM (Pediatric Index of Mortality) score in a tertiary care pediatric ICU. The Indian Journal of Pediatrics. 2010; 77(3):267-71.
  2. Costa GA, Delgado AF, Ferraro A, Okay TS. Application of the pediatric risk of mortality (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit. Clinics. 2010; 65:1087-92.
  3. Khajeh A, Noori NM, Reisi M, Fayyazi A, Mohammadi M, Miri-Aliabad G. Mortality risk prediction by application of pediatric risk of mortality scoring system in the pediatric intensive care unit. Iranian Journal of pediatrics. 2013; 23(5):546.
  4. Patel S, Vasavada H, Patel P, Patel B, Shukla P. Study of PRISM III score as a predictor of mortality in PICU. Journal of Pediatric Critical Care. 2019; 6(3):21.
  5. Slater A, Shann F, Group APS. The suitability of the Pediatric Index of Mortality (PIM), PIM2, the Pediatric Risk of Mortality (PRISM), and PRISM III for monitoring the quality of pediatric intensive care in Australia and New Zealand. Pediatric Critical Care Medicine. 2004; 5(5):447-53.
  6. Abdelkader A, Shaaban MM, Zahran M. Using two scores for the prediction of mortality in pediatric intensive care units. Al-Azhar Assiut Medical Journal. 2018; 16(4):349.
  7. Khurana D, Deoke SA. Thrombocytopenia in critically ill patients: clinical laboratory trial behavior and its correlation with short-term outcome during hospitalization. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2017; 21(12):861.
  8. Chakraverty R, Davidson S, Peggs K, Stross P, Garrard C, Littlewood T. The incidence and cause of coagulopathies in an intensive care population. British journal of hematology. 1996; 93(2):460-3.
  9. Aman I, Hassan KA, Ahmad TM. The study of thrombocytopenia in sick neonates. Journal of the College of Physicians and Surgeons--Pakistan JCPSP. 2004; 14(5):282-5.
  10. Saxonhouse MA, Christensen RD, Walker DM, Hutson AD, Sola MC. The concentration of circulating megakaryocyte progenitors in preterm neonates is a function of post-conceptional age. Early human development. 2004; 78(2):119-24.
  11. Franchini M, Veneri D, Lippi G. Thrombocytopenia and infections. Expert review of hematology. 2017; 10(1):99-106.
  12. Kam T, Alexander M. Drug-induced immune thrombocytopenia. Journal of pharmacy practice. 2014; 27(5):430-9.
  13. Lee E-J, Lee AI. Thrombocytopenia. Primary Care: Clinics in Office Practice. 2016; 43(4):543-57.
  14. Lovecchio F. Heparin-induced thrombocytopenia. Clinical Toxicology. 2014 2014/07/01; 52(6):579-83.
  15. Wang HL, Aguilera C, Knopf KB, Chen T-MB, Maslove DM, Kuschner WG. Thrombocytopenia in the intensive care unit. Journal of intensive care medicine. 2013; 28(5):268-80.
  16. Zarychanski R, Houston DS. Assessing thrombocytopenia in the intensive care unit: the past, present, and future. Hematology 2014, the American Society of Hematology Education Program Book. 2017; 2017(1):660-6.
  17. Rang NN, Cong PH. Is thrombocytopenia one of the useful predictive markers of mortality in pediatric shock patients? JMR. 2020; 136:12.
  18. Sah VK, Giri A, Milan K, Niraula N. Association of Thrombocytopenia and Mortality in critically ill children admitted to PICU in tertiary Hospital in Biratnagar. Birat Journal of Health Sciences. 2019; 4(1):649-53.
  19. Popli V, Kumar III A. Validation of PRISM III (Pediatric Risk of Mortality) scoring system in predicting risk of mortality in a pediatric intensive care unit. Children. 2018; 50(200):65-75.
  20. Glance LG, Osler TM, Dick A. Rating the quality of intensive care units: is it a function of the intensive care unit scoring system Critical care medicine. 2002; 30(9):1976-82.
  21. Strand K, Flaatten H. Severity scoring in the ICU: a review. Acta Anaesthesiologica Scandinavica. 2008; 52(4):467-78.