To evaluate the utility of age-adapted SOFA score in predicting mortality in paediatric severe sepsis: A prospective observational cohort study

Abstract

Objective:

To determine the usefulness of repeated measurement the SOFA score for prediction of mortality in PICU patients.

 Methods:

235 patients were enrolled for study from October 2018 to January 2021 at Paediatrics department. Clinical characteristics of the patients were recorded and different systemic physiological parameters were also recorded. The highest and lowest values of these parameters during the first 24 hours of ICU admission (DAY1) were captured, and the recording was repeated at 72 hours (DAY 3) of PICU admission (i.e., from 48-72 hours)

Findings:

Significant correlation between mortality and SOFA score, with higher scores observed in non-survivors compared to survivors, consistent with previous studies. On day 1, the SOFA score showed good predictive ability with an AUROC of 0.842. A pSOFA score of 7.5 or higher predicted mortality with 80.9% sensitivity and 78% specificity. On day 3, a SOFA score of 9.5 or higher performed best in identifying patients at higher risk of mortality, with excellent sensitivity (93.6%) and specificity (88.2%).

Novelty:

 SOFA score, particularly the age-adapted pSOFA score, is an excellent predictor of mortality in critically ill pediatric patients with sepsis. Implementing the pSOFA score may improve the management and outcomes of pediatric sepsis.