Evaluation of Signs of Inflammation that Can Kill score in predicting mortality in an urban tertiary care centre for children in South India


  • N. Rajeshwari Department of Pediatrics, Dr. Kamakshi Memorial Hospital, Pallikaranai, Chennai, Tamil Nadu, India
  • Savitha A. Department of Pediatrics, Dr. Kamakshi Memorial Hospital, Pallikaranai, Chennai, Tamil Nadu, India




Early intervention, Golden hour, Mortality, ROC, SICK score, Triage


Background: Mortality in critically ill children is maximum in the first 24 hours. Need of the hour is a rapid clinical scoring system that predicts mortality on admission. This study aims at using the Signs of Inflammation that Can Kill (SICK) score in a tertiary care pediatric hospital in India, to evaluate its usefulness in predicting mortality on admission.

Methods: The study design is a hospital based prospective study for evaluation of diagnostic test for a duration of one year.  The assessment using SICK score was done on arrival prior to initiation of treatment for children admitted through the emergency room and paediatric ward. The variables of SICK score - temperature, heart rate, respiratory rate, systolic BP, oxygen saturation, CRT, sensorium by AVPU scale were measured using standard guidelines.

Results: The study includes a population of 369 children. Children between 1 month to 12 years were included in the study. Out of 369 children studied 24 died. The mortality in the study is 6.5%. The area under the ROC curve is 0.94, which indicates the scores based on regression could predict mortality in 94% subjects correctly. Further a score of 2.5 showed maximum discrimination with a sensitivity of 87.5% and specificity of 87.2%.

Conclusions: The assessment of SICK score in the population will provide objective measure of severity of illness on admission, prediction of mortality, early triage of patients, effective allocation of resources and personnel, enables early intervention, which helps in reducing mortality.


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