Use of a Mortality Prediction Model in Children on Mechanical Ventilation: A 5-Year Experience in a Tertiary University Hospital

Figures & data

Figure 1 Schematic illustration of the patient selection criteria.

Note: A total of 400 children who were ventilated in the pediatric intensive care unit over the past 5 years were included.

Table 1 Distribution of Individual Characteristics in Relation to Mortality Rate

Characteristics of the Participants	Patients Who Survived		Deceased Patients		Total Number of Participants	X^2	df	P value
	(N = 335)	%	(N = 65)	%	N = 400
Age (NICHD classification)								0.773*
Infancy (≤1 year)	87	87.00	13	13.00	100
Toddlerhood (>1–2 years)	54	79.41	14	20.59	68
Early childhood (>2–5 years)	90	83.33	18	16.67	108
Middle childhood (6–11 years)	80	83.33	16	16.67	96
Early adolescence (12–18 years)	24	85.71	4	14.29	28
Gender						2.21	1	0.137
Male	183	81.33	42	18.67	225
Female	152	86.86	23	13.14	175
Comorbidity						19.40	1	<0.001
Yes	230	89.84	26	10.16	256
No	105	72.92	39	27.08	144
Cause of PICU admission								<0.001*
Respiratory problems	97	78.23	27	21.77	124
Cardiac problems	58	76.32	18	23.68	76
Central nervous system problems	57	83.82	11	16.18	68
Others
Endocrine diseases	25	100	0	0.00	25
Gastrointestinal diseases	33	100	0	0.00	33
Renal diseases	16	76.19	5	23.81	21
Hematological disorders	8	100	0	0.00	8
Surgical conditions	20	100	0	0.00	20
Others	21	84.00	4	16.00	25
Number of organ failure						100.50	2	<0.001
One	217	99.09	2	0.91	219
Two	69	78.41	19	21.59	88
Three or more	49	53.26	43	46.74	92
Sepsis						7.87	1	0.005
No	207	88.09	28	11.91	235
Yes	128	77.58	37	22.42	165

Notes: *P value from the Fisher’s exact test. The chi-square test and Fisher’s exact test were used to examine differences in the distribution of categorical variables between participants who survived and those who did not.

Figure 2 Receiver operating characteristic curve for the SEPM model and PRISM III score.

Figure 3 Line graph showing the sensitivity and specificity of the SEPM model according to several cutoff points for the predictive probability.

Table 2 Summary of SEPM Model Estimates and Statistics

Variables	Given Code	Coefficient	SE	z	P value	OR	Lower CI	Upper CI
Weight (kg)	kg	−0.12	0.03	−4.35	<0.001	0.88	0.84	0.93
Age
Infancy (≤1 year)	0	Reference
Toddlerhood (>1–2 years)	1	1.53	0.64	2.40	0.016	4.60	1.32	15.99
Early childhood (3–5 years)	2	2.65	0.76	3.48	<0.001	14.19	3.19	63.17
Middle childhood (6–11 years)	3	2.83	0.83	3.39	0.001	16.93	3.30	86.80
Early adolescence (12–18 years)	4	1.94	1.23	1.58	0.115	6.97	0.62	78.08
Comorbidity
No	0	Reference
Yes	1	1.26	0.42	2.99	0.003	3.52	1.55	8.04
Cause of admission
Others	0	Reference
Respiratory problems	1	1.70	0.61	2.79	0.005	5.50	1.66	18.21
Cardiac disorders	2	2.08	0.65	3.22	0.001	8.00	2.25	28.39
CNS disease	3	1.24	0.71	1.74	0.082	3.46	0.85	13.98
Number of organ failure	Number	1.86	0.25	7.37	<0.001	6.40	3.91	10.49
Sepsis
No	0	Reference
Yes	1	0.96	0.40	2.42	0.016	2.61	1.20	5.66
Constant		−7.26	0.99	−7.29	<0.001	0.001	0.000	0.005
Model fitting evaluation statistics			df	X^2	p value
Likelihood test			11	170.86	<0.001
Wald test			11	74.01	<0.001
Hosmer–Lemeshow test (10 groups)			8	25.93	0.001

Abbreviations: SEPM, simple early predictive mortality model; PICU, pediatric intensive care unit; KFUH, King Fahd University Hospital; PRISM, Pediatric Risk of Mortality Score; PIM, Pediatric Index of Mortality; BIC, Bayesian Information Criterion; AIC, Akaike Information Criterion; ROC, receiver operating characteristic; CPR, cardiac pulmonary resuscitation.