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The author replies.

The letter by Spentzas (1) presents several interesting issues regarding severity of illness scores and their uses. Spentzas (1) comments that Pediatric Risk of Mortality (PRISM) “carries issues from the past structure of the PICU.” Actually, the current series of investigations are designed to not only meet the evolutionary changes of the PICU but also stimulate future PICU assessments to keep up with the new focus of pediatric critical care and the prevention of morbidity and mortality. First, the National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network developed a measure of morbidity, the Functional Status Score, that is suitable for use in large-scale pediatric such as those required for quality studies (2). Second, the CPCCRN revised the time period for collecting the PRISM score to better separate the assessment of severity of illness (physiological instability) from the outcome (3). Third, the CPCCRN will construct predictors of both morbidity and mortality. This prospective dataset of over 10,000 patients is nearing completion.