*, Shifa Nismath and Rao, Suchetha S and Baliga, Shantharama B and Rao, Gayathri M and Kulkarni, Vaman (2021) Comparison of urine albumin creatinine ratio with the pediatric index of mortality 2 score for prediction of pediatric intensive care unit outcomes. Irish Journal of Medical Science, 190 (4). pp. 1481-1485. ISSN 00211265

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Abstract

Background Predicting morbidity and mortality in a pediatric intensive care unit (PICU) is of extreme importance to make precise decisions for better outcomes. Aim We compared the urine albumin creatinine ratio (ACR) with the established PICU score, pediatric index of mortality 2 (PIM 2) for predicting PICU outcomes. Methods This cross-sectional study enrolled 67 patients admitted to PICU with systemic infammatory response syndrome. Urine ACR was estimated on admission, and PIM 2 score was calculated. ACR was compared with PIM 2 for PICU outcome measures: the need for inotropes, development of multiple organ dysfunction syndrome (MODS), duration of PICU stay, and survival. Results Microalbuminuria was found in 77.6% of patients with a median ACR of 80 mg/g. ACR showed a signifcant association with the need for inotropes (p<0.001), MODS (p=0.001), and signifcant correlation to PICU stay (p 0.001, rho=0.361). The area under the receiver operating characteristic curve for ACR (0.798) was comparable to that of PIM 2 (0.896). The cutof value of ACR derived to predict mortality was 110 mg/g. The study subjects were divided into 2 groups: below cutof and above the cutof. Outcome variables, inotrope use, MODS, mortality, and PICU stay compared between these subgroups, were statistically signifcant. Conclusion ACR is a good predictor of PICU outcomes and is comparable to PIM 2 for mortality prediction

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