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  1. A report of the use of the Dynamic Objective Risk Assessment (DORA) score in the changing pediatric intensive care environment.

    Article - En anglais

    Objective 

    To assess the clinical use of the Dynamic Objective Risk Assessment (DORA) severity of illness score in a site remote from its development.

    Design 

    Prospective chart review.

    Setting 

    Tertiary referral pediatric intensive care unit (PICU).

    Patients 

    One hundred sixty consecutive admissions involving 621 patient days.

    Interventions 

    None.

    Measurements and Main Results 

    Pediatric Risk of Mortality (PRISM) scores were collected daily for all PICU patient days.

    Collection of data was performed by a physician not directly involved in the ordering of vital signs or laboratory data.

    The daily DORA score was calculated from the previous day's PRISM score and the admission PRISM score according to a previously described formula.

    The DORA score determines the patient's risk of mortality for the next 24 hrs.

    Also documented were the tests not ordered for each patient day.

    The sensitivity and specificity of the DORA score in our patient population were very similar to that previously reported using the previously described 1% cutoff for predicted mortality.

    We also noted that the tests ordered were related to the physician's perception of the patient's degree of sickness, and were themselves predictive of outcome.

    Conclusion 

    An outcome scoring system created in one group of PICUs can be applied to patients in another PICU remote from where the scoring system was developed with similar ability to predict outcome.

    Mots-clés Pascal : Unité soin intensif, Pédiatrie, Analyse risque, Mortalité, Epidémiologie, Analyse statistique, Méthodologie, Etude comparative, Enfant, Homme

    Mots-clés Pascal anglais : Intensive care unit, Pediatrics, Risk analysis, Mortality, Epidemiology, Statistical analysis, Methodology, Comparative study, Child, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0463860

    Code Inist : 002B27B14C. Création : 19/02/1999.