Study of predictive value of pediatric risk of mortality (PRISM) score in children with end stage liver disease and fulminant hepatic failure

Autor: Wafaa El-Akel, Nehal El-Koofy, Noha Adel Yassin, Mortada M. El-Shabrawi, Mona E. Fahmy, Hanaa M. El-Karaksy, Nabil A. Mohsen
Rok vydání: 2010
Předmět:
Zdroj: Indian journal of pediatrics. 78(3)
ISSN: 0973-7693
Popis: To evaluate the use of the PRISM score as a predictor of outcome in patients with end stage liver disease (ESLD) and fulminant hepatic failure (FHF). The present study included 30 patients with ESLD and FHF, with ages ranging from 2 to 108 months, who were admitted to the Emergency room (ER) and the Pediatric Hepatology Unit at Cairo University Children’s Hospital (tertiary referral hospital) over a six-month-period from May through October 2008. Survivors were followed up for 6 months. Two other scores were also calculated, the PELD score and the Child-Pugh score. The outcome was defined as survivors and deceased. Deceased patients as compared with survivors were significantly younger (median age 7 vs. 24 months, p = 0.003). A ROC curve was constructed for the PRISM score, the predicted death rate (PDR) and the PELD score in the 30 patients. PRISM score was significantly associated with mortality (p = 0.04). The best cut off value was 9.5 (70.6% sensitive and 61% specific). PDR was also significantly associated with mortality (p = 0.011). The best cut off value for PDR was 5.95 (70.6% sensitive, 85% specific). On the other hand, the PELD score was not associated with mortality (p = 0.202). PRISM score can be applied with an adequate degree of accuracy for severity assessment and mortality prediction to pediatric patients with ESLD or FHF.
Databáze: OpenAIRE