PEDIATRIC RISK OF MORTALITY III SCORE

Cardiovascular and Findings Points

neurologic vital signs
Systolic blood pressure Neonate and >55 0
(mmHg) Neonate and 40-55 3
Neonate and <40 7
Infant and >65 0
Infant and 45-65 3
Infant and <45 7
Child and >75 0
Child and 55-75 3
Child and <55 7
Adolescent and >85 0
Adolescent and 65-85 3
Adolescent and <65 7
Heart rate (beats/min) Neonate and <215 0
Neonate and 215-225 3
Neonate and >225 4
Infant and <215 0
Infant and 215-225 3
Infant and >225 4
Child and <185 0
Child and 185-205 3
Child and >205 bpm 4
Adolescent and <145 bpm 0
Adolescent and 145-155 bpm 3
Adolescent and >155 bpm 4
Temperature (°C) <33 3
33-40 0
>40 3
Mental status Glasgow coma score ≥8 0
Glasgow coma score <8 5
Pupillary response Both reactive 0
One reactive and (1 fixed and >3 mm) 7
Both fixed and both >3 mm 11

Acid-base and blood Findings Points

gases
Acidosis (mEq/L) pH >7.28 and total CO2 ≥17 0
pH 7.0-7.28 or total CO2 5-16.9 2
pH<7.0 or total CO2 <5 6
pH <7.48 0
7.48-7.55 2
>7.55 3
PCO2 (mmHg) <50 0
50-75 1
>75 3
Total CO2 (mEq/L) ≤34 0
>34 4
PaO2 (mmHg) ≥50 0
42.0-49.9 3
<42 6
Chemistry tests Findings Points
Glucose (mg/dL) ≤200 0
>200 2
Potassium (mEq/L) ≤6.9 0
>6.9 3
Creatinine (mg/dL) Neonate and ≤0.85 0
Neonate and >0.85 2
Infant and ≤0.90 0
Chemistry tests Findings Points

Glucose (mg/dL) ≤200 0

>200 2
Potassium
(mEq/L) ≤6.9 0
>6.9 3
Creatinine
(mg/dL) Neonate and ≤0.85 0
Neonate and >0.85 2
Infant and ≤0.90 0

Total PRISM III score=(cardiovascular and neurologic subscore) + (acid base and blood gas subscore) + (chemistry subscore) + (hematology
subscore)
Interpretation
Minimum subscore and total score: 0
Maximum cardiovascular and neurologic subscore: 30
Maximum acid-base and blood gas subscore: 22
Maximum chemistry subscore: 10
The higher the total score, the worse the prognosis A rising score indicates deterioration
 Paediatric Index of Mortality 3

Variable Coefficients
Pupils fixed to light? (Yes/No) 3.8233 (3.4581–4.1885)
Elective admission (Yes/No) –0.5378 (–0.7234 to –0.3522)
Mechanical ventilation in the first 0.9763 (0.8234–1.1293)
hour (Yes/No)
Absolute value of base excess (mmol/L) 0.0671 (0.0576–0.0766)
SBP at admission (mm Hg) –0.0431 (–0.0524 to –0.0338)
SBP2/1,000 0.1716 (0.1248–0.2183)

100 × Fio2/Pao2 (mm Hg) 0.4214 (0.3313–0.5115)

Recovery post procedure?
Yes, recovery from a bypass cardiac
procedure
Yes, recovery from a non-bypass cardiac
procedure
Yes, recovery from a noncardiac procedure
Very high-risk diagnosis (Yes/No)
High-risk diagnosis (Yes/No)
Low-risk diagnosis (Yes/No)
Constant
–1.2246 (–1.4915 to –0.9576)
–0.8762 (–1.2418 to –0.5106)
–1.5164 (–1.7998 to –1.233)
1.6225 (1.4706–1.7744)
1.0725 (0.9071–1.238)
–2.1766 (–2.4825 to –1.8708)
–1.7928 (–2.2763 to –1.3093)