الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The Pediatric Risk of Mortality Score III (PRISM III) has been designed to help physicians to predict probable outcome and risk of mortality of the patients being admitted into the pediatric intensive care unit PICU. PRISM III scoring system provides health care administrators an outlook regarding patient’s prognosis. It provides medical staff with epidemiological criteria and may help in decision making for PICU admissions and correct identification of patients who might benefit from such care. PRISM score used the worst physiologic and laboratory values of patients on the day of admission to predict PICU mortality (Anjali et al., 2023). Variables are designed for pediatric age and may not be suitable for neonates.
The perfusion index (PI), translating the real time variations of the pulse oximetry signal in the peripheral circulation, has emerged as an easily applicable, non-invasive and continuous parameter that reflects changes in the cardiac output and vasomotor tone. It monitors microcirculation in less vital tissues could allow early identification of vital tissue hypoperfusion, before the installation of decompensated shock leading to organ failure (Fister and Grosek, 2017). In particular, low PI values have been demonstrated to be an accurate predictor for high illness severity in newborns (Montiero et al., 2017).
The present study adjusted the PRISM score III to neonatal based parameters score; neonatal modified PRISM score III (NM PRISM score III). Then the NM PRISM score III will be tested to identify its feasibility in being a good tool for assessing outcomes in critically ill neonates. Perfusion index will also be used as an adjuvant to the NM PRISM score III as an indicator of peripheral circulation.
The Aim of This Work was To validate the use of the NM PRISM score III in predicting risk of mortality and/or prognosis in NICUs within the first 24 hours of admission, and to validate the combined use of the NM PRISM score III and Perfusion Index (PI) in predicting the risk of mortality risk/prognosis in NICUs within the first 24 hours of admission to help in guidance of accurate, properly timed management.
In this prospective study, we studied the total hospital course of 112 neonates admitted to NICU over 6 months ,46.4% were preterm neonates and 53.6% were full term neonates ,The mean post natal age of the participants was 5.54 days. There were 50.9% males and 49.1% females enrolled in this study.
we tested the performance of the following prognostic scoring systems (original PRISM score III, NM PRISM score III ,PI, Combined use of NM PRISM score III , PI and SNAP II score) to predict mortality in critically ill neonates at day1 and day3 of admission.
In this study, we found that NM PRISM score III at day 1 of admission represented a good tool for prediction of mortality but at day 3 it was more statistically significant. The combined use of NM PRISM score III and PI at day 1 of admission also had a good discriminative power for prediction of mortality but at day 3 it offered the best discriminative tool for prediction of mortality and morbidity (use of MV, use of inotropic support and sepsis) than other individual scores.