Perbandingan Skor Prism III dan Prism IV sebagai Prediktor Mortalitas pada Anak Sakit Kritis di Ruang Rawat Intensif Anak Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Background: Critical illness is collection conditions and disorders that have impact on the occurrence of organ dysfunction, prolonged morbidity and mortality. Score of mortality objectively calculates the severity of disease and predicts risk of mortality according to the clinical condition of patient. Today, no standardized scoring system that used in PICU for initial assessment of patients in Indonesia yet. Objective: Comparing mortality’s predictor ability between PRISM III and PRISM IV score as predictors of mortality in critically ill children at PICU Haji Adam Malik Hospital Medan. Methods: Prospective cohort study was conducted in PICU of Haji Adam Malik General Hospital from September 2020 to March 2021. Characteristics of the sample were obtained through the medical record of patients treated in PICU. Assessment of PRISM IV and PELOD-2 score was carried out on the first and third days of patient being admitted in PICU. Results: Retrospective study was conducted from March 2022 to August 2022. Characteristics of the sample were obtained through the medical record of patients treated in PICU. Assessment of PRISM III and PRISM IV score was carried out on the first 4 hours patient being admitted in PICU. Based on the study, there was 54 children who were treated. There were 19 (35,2%) treated with respiratory problems. There were 30 (55,6%) children died. PRISM III and PRISM IV could predict mortality of children with critical illness with area under curve respectively 74,2% and 90,1%. From Chi Square test, PRISM IV with cutoff point 5,5 has relative risk value 3,538. Conclusion: PRISM IV score could predict mortality better than PRISM III of critically ill children at PICU Haji Adam Malik Hospital Medan.