paediatrics

Paediatric Index of Mortality 3 (PIM3)

Predicts the risk of death for children (< 16 years in the original model; < 18 in PIM3) admitted to intensive care, from values in the first hour. Designed for benchmarking units, not for individual decisions.

Pupils fixed to light (both > 3 mm and fixed; not drug-induced)*

Elective admission to ICU (planned, e.g. after elective surgery)*

Mechanical ventilation at any time in the first hour (including mask / nasal CPAP or BiPAP)*

Systolic blood pressure*(mmHg)

First value in ICU. Cardiac arrest: 0; shock with BP too low to measure: 30; not known: 120.

Base excess (arterial or capillary)*(mmol/L)

Not measured: enter 0.

FiO₂ at the time of the PaO₂*(fraction)

e.g. 0.21 for room air. Enter 0 if no PaO₂.

PaO₂ (arterial)*(kPa)

No arterial PaO₂ in the first hour: enter 0 (PIM3 then uses 0.23).

Main reason for ICU admission is recovery from surgery or a procedure*

Diagnosis category (choose the highest that applies)*

Score interpretation

Predicted Risk of Death in ICU (PIM3) 0–100

PIM3 predicted probability of death (%). It is calibrated for comparing observed with expected mortality across a unit or network, not for prognosis or treatment decisions for an individual child.

→ Record within the first hour of ICU care; use for audit and standardised mortality ratios (e.g. PICANet / ANZPIC).

Interpretation bands for the PIM3. Apply clinical judgement and local guidance.

References

Straney L, Clements A, Parslow RC, et al. Paediatric index of mortality 3: an updated model for predicting mortality in pediatric intensive care. Pediatr Crit Care Med. 2013;14(7):673–681.

Curated clinical cross-links plus same-class fallbacks.

Calculators

RACHS-1 — Risk Adjustment for Congenital Heart SurgeryRecommended
Cardiac Surgery

Same class

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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