EVALUATION OF SICK (SIGNS OF INFLAMATION THAT CAN KILL) SCORE IN PREDICTING MORTALITY AND DURATION OF STAY OF PATIENTS IN PICU IN RURAL TERTIARY CARE CENTRE

Background: Mortality in critically ill children occurs in first 24 hour of admission. Therefore, immediate assessment of children at admission with a rapid clinical score is required. Early identification and proper triage of patients, allocation of available resources based on severity of illness is essential for effective management of critical illness. In this study SICK SCORE is used to predict mortality at admission. Methods: This is a prospective observational study of 100 patients over a period of two years at a rural tertiary center. The assessment using SICK SCORE was done on arrival prior to initiation of treatment for children admitted in PICU. A SICK SCORE variable (temperature, heart rate, respiratory rate, systolic blood pressure, saturation, capillary refill time, sensorium by AVPU scale) was measured using standard guidelines. Each variable is scored 0 to 1, higher the score higher is the prediction of mortality. Results: The study included 100 children admitted in PICU, children between 1 month to 17yr were included in this study, there were 10 deaths (all three had SICK SCORE>6, with 70% sensitivity and specificity 5 %) during study period of 2 years. The mortality risk and duration of stay was found to be increasing with increase in SICK score. Conclusion: Substantially increased rate of mortality and lengthy duration of hospital stay was observed among SICK children who had higher sick score at admission. Hence, we conclude, SICK score is extremely useful in predicting mortality and lengthy stay on admission to hospital and it is also simple and cost-effective scoring system for triaging in resource limited settings.