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There is no method to accurately predict survival with intact neurologic function as opposed to death or survival with severe brain injury following a submersion injury (SI). The Pediatric Risk of Mortality Score (PRISM) is a scoring system which predicts mortality in critically ill children. The mortality risk is computed from the following equation: OBJECTIVE: To evaluate the use of the PRISM score in distinguishing which children presenting to an Emergency Department (ED) will die or survive with severe neurologic impairment from those who will survive with intact neurologic findings following SI. METHODS: The medical records of all SI patients ages 1 day to 18 years who presented to the RWJUH-ED from 1986 to 1995 were retrospectively analyzed for demographic data and a PRISM Score for each patient was computed(N=50). Patients were assessed for survival and neurologic outcome which was defined by the Pediatric Cerebral Performance Category Scale. Patients were assigned to 1 of 3 groups: INTACT SURVIVAL (I): Recovery of pre-SI neurological function or mild neurologic impairment (ataxia, learning disabilities). DIED (D): As a result of the SI. NEUROLOGIC IMPAIRMENT (NI): Coma, spasticity, no self help skills. All data was analyzed using the Wilcoxon Rank Sum Test.Table CONCLUSIONS: 100% of patients with a PRISM Probability ≥ 50% D or had NI. When PRISM Probability was < 50%, all patients had I. The PRISM score accurately distinguished death and NI from I following SI.

PREDICTORS OF DEATH AND NEUROLOGIC IMPAIRMENT IN PEDIATRIC SUBMERSION INJURIES: THE PEDIATRIC RISK OF MORTALITY SCORE • 318