Abstract: Objective · To evaluate the application effect of the newly updated pediatric critical illness score PRISM Ⅳ on assessing the condition of children with mechanical ventilation after congenital heart disease (CHD). Methods · T test, area under ROC curve and Hosmer-Lemeshow goodness of fit test were used to assess the performance of PRISM Ⅳ . The performance of PRISM Ⅳ was also compared with PRISM Ⅲ and specific severity of illness scoring system for CHD. Results · 230 children with CHD were included. Reliability among evaluators was good. The discriminatory power (AUC>0.75) and calibration capability (P>0.05) of PRISM Ⅳ , PRISM Ⅲ and specific score for CHD were tolerable. The results of PRISM Ⅳ evaluation were similar to specific scores for CHDT0-4 and CHDT0-12 (P>0.05). Conclusion · PRISM Ⅳ has been updated to shorten the assessment time and has certain advantages over other tools. It is recommended that nursing staff take it in the prognosis prediction system for critically ill children based on clinical status and practical needs, to detect high-risk children early, and to intervene early to reduce the complications and mortality of children.

Key words: severity of illness scoring system, mechanical ventilation, congenital heart disease, early warning