Prognostic Value of the pSOFA Score for Mortality Among Critical Ill Children Admitted to Pediatric Intensive Care Unit

Abstract

Objectives: This study aimed to evaluate the prognostic value of the pediatric Sequential Organ Failure Assessment score (pSOFA) for mortality among critically ill patients in pediatric intensive care unit (PICU) and to compare with Pediatric Risk of Mortality version III (PRISM III), Pediatric Index of Mortality version 3 (PIM-3), and Pediatric Logistic Organ Dysfunction version 2 (PELOD-2) scores in predicting mortality in severe pediatric patients. Methods: This prospective descriptive study enrolled patients aged from 1 month to 15 years old admitted to the PICU of Vietnam National Children's Hospital from April 2023 to October 2023. Clinical and laboratory variables were recorded at the time of admission.  pSOFA, PRISM III, PIM-3, and PELOD-2 scores were calculated, and treatment outcomes were recorded. Results: pSOFA score demonstrated excellent prognostic capability for mortality in the PICU with an area under the curve (AUC) of 0.928 (p < 0.05); at a cut-off score of 12, the sensitivity was 88.5% and specificity was 87.6%.  pSOFA score was directly proportional to the predicted mortality, reflecting the actual mortality rate of the study population across various patient groups and disease models. Compared to PRISM III, PIM-3, and PELOD-2 scores, pSOFA exhibited superior predictive power for mortality, with more accurate mortality predictions relative to actual rates and a higher ability to differentiate between survival and mortality groups. Conclusion: pSOFA score is highly effective for predicting mortality in critically ill pediatric patients and provides more accurate predictions than PRISM III, PIM-3, and PELOD-2 scores.