Accuracy of SIRS, age-adapted pSOFA, and quick SOFA scoring systems for predicting outcomes in paediatric patients with sepsis: a meta-analysis

Sun, Jingmin; Li, Jing; Wu, De; Deng, Fang

doi:10.1016/j.pedneo.2021.09.006

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…1 Lastly, Sun et al reported a sensitivity of 83%, a specificity of 72%and a diagnostic accuracy of 85%. 18 While all the studies report that pSOFA has an adequate prediction ability in terms of mortality, there is a discrepancy within the results. We assume that this occurred because while other studies assessed patients at the time of admission, we conducted serial assessments, which improved diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 97%

Accuracy of pSOFA Score in Predicting Outcomes in Critically Ill Children

Zamir

Nadeem

Tabussam

2023

PAFMJ

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Objectives: To determine the diagnostic accuracy of the pSOFA score in predicting mortality in critically ill pediatric patients. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Aug 2021 to Feb 2022. Methodology: We studied 76 critically ill paediatric patients. All patients underwent pSOFA scoring on admission and then at 72 hours post-admission and were followed up till discharge or till mortality occurred. A pSOFA score of >10 was considered a high mortality risk. The two-by-two table was constructed to calculate the sensitivity, specificity and diagnostic accuracy of the pSOFA score in predicting the occurrence of death. Results: The pSOFA score had a sensitivity of 88.9% at Day-0, which improved to 100% by Day-7 in predicting whether mortality occurred. The specificity was 80.6% on Day-0 and 97.0% on Day-7. The diagnostic accuracy of pSOFA in predicting mortality was 81.6% when performed on the day of admission, which increased to 90.8% when calculated on Day 3 and was the highest on Day-7 when it was 97.4%. Conclusion: The pSOFA score has good diagnostic accuracy in predicting the occurrence of mortality in paediatric patients admitted to intensive care, which increases as the length of stay increases.

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Section: Discussionmentioning

confidence: 97%

Accuracy of pSOFA Score in Predicting Outcomes in Critically Ill Children

Zamir

Nadeem

Tabussam

2023

PAFMJ

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“…17 The pSOFA score provided excellent discrimination of inhospital mortality in critically ill children with sepsis (AUC, 0.92; 95% CI, 0.91-0.94) and its performance was better than the other organ dysfunction scores and similar to PRISM III (AUC 0.88; 95% CI, 0.86-0.91), with a mortality rate of 12.1% in children with sepsis, and a mortality rate of 32.3% in children with septic shock. 30,31 A previous study demonstrated the ability of the pSOFA score to predict mortality in PICU patients with sepsis with a sensitivity of 83% (95% CI, 76-88%) and specificity of 72% (95% CI, 60-81%).…”

Section: Discussionmentioning

confidence: 99%

Pediatric sepsis diagnostic and prognostic biomarkers: pancreatic stone protein, copeptin, and apolipoprotein A-V

et al. 2023

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Background We assessed serum concentrations of pancreatic stone protein (PSP), copeptin, and apolipoprotein A-V (APOA5) biomarkers for the diagnosis and prognosis of pediatric sepsis, a condition associated with high mortality. Methods This prospective study included 180 children admitted to the Pediatric Intensive Care Unit and 100 healthy controls at Menoufia University Hospital. Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality-2 (PIM2), and Pediatric Sequential Organ Failure Assessment (pSOFA) scores were calculated. Serum PSP, copeptin and APOA5 were measured once within 24 h of admission. Results PSP, copeptin, and APOA5 were significantly higher in the patients than in the controls (p < 0.001). PSP and copeptin were increased among children who required mechanical ventilation (MV), had multiple organ dysfunctions, and were non-survivors, but APOA5 was decreased in those children. Logistic regression analyses showed that high pSOFA, high PSP and copeptin, low APOA5, and use of MV were associated with mortality. The receiver operating characteristic revealed that the area under the curve (AUC) for APOA5, copeptin, and PSP (0.965, 0.960, and 0.868, respectively) demonstrated high sensitivity (96%, 94%, and 80%) for sepsis diagnosis. The AUC values for PSP, copeptin, and APOA5 were 0.709, 0.705, and 0.571, respectively, with sensitivities of 74%, 58%, and 58% for mortality prediction. Conclusions PSP, copeptin, and APOA5 are promising diagnostic biomarkers for pediatric sepsis but inadequate predictors of mortality. Impact Apolipoprotein A-V (APOA5), copeptin, and pancreatic stone protein (PSP) are acute-phase proteins with diagnostic value in evaluating critically ill pediatric patients with sepsis and detecting sepsis severity. PSP and copeptin had the power to discriminate non-survivors from survivors. APOA5 was less powerful than the other biomarkers in discriminating between survivors and non-survivors.

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“…The findings led to the conclusion that pSOFA and PELOD2 scores serve as reliable predictors of mortality in critically ill children. Sun et al reported SOFA being superior to SIRS for predicting mortality in PICU patients with sepsis [ 12 ]. The pSOFA score, an age-adjusted pediatric version of the adult SOFA score, was adapted and validated by Matics et al and used it to evaluate the Sepsis-3 definitions in critically unwell children.…”

Section: Reviewmentioning

confidence: 99%

Pediatric Sequential Organ Assessment Score: A Comprehensive Review of the Prognostic Marker in the Pediatric Intensive Care Unit

Malik,

Taksande,

Meshram

2024

Cureus

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Critically ill children admitted to the pediatric intensive care unit (PICU) face a substantial risk of morbidity and mortality, regardless of whether they are in developed or developing countries. To aid in treatment planning, various prognostic scoring systems have been developed to predict the likelihood of morbidity and death in these young patients. While the sequential organ failure assessment (SOFA) score has been validated as an independent risk predictor for adult mortality in cases of confirmed or suspected sepsis, it is not suitable for use in children due to its lack of age normalization. Children in critical condition often exhibit significant deviations from the normal physiological balance of their bodies. These deviations from the typical range of physiological variables can be leveraged to estimate the extent of these variations and create scoring systems. In this context, the pediatric SOFA (pSOFA) score was developed by modifying the original SOFA score and incorporating age-adjusted cutoffs for various bodily systems. The objective of this review is to assess the effectiveness of the pSOFA score in predicting sepsis-related mortality in pediatric patients within the PICU setting.

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Accuracy of SIRS, age-adapted pSOFA, and quick SOFA scoring systems for predicting outcomes in paediatric patients with sepsis: a meta-analysis

Cited by 7 publications

References 30 publications

Accuracy of pSOFA Score in Predicting Outcomes in Critically Ill Children

Accuracy of pSOFA Score in Predicting Outcomes in Critically Ill Children

Pediatric sepsis diagnostic and prognostic biomarkers: pancreatic stone protein, copeptin, and apolipoprotein A-V

Pediatric Sequential Organ Assessment Score: A Comprehensive Review of the Prognostic Marker in the Pediatric Intensive Care Unit

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