Comparative performance of the phoenix sepsis criteria and procalcitonin for mortality prediction in pediatric sepsis

Abstract Background Sepsis is the leading cause of childhood mortality worldwide. Accurate prediction of mortality is crucial for timely intervention. This study compared the Phoenix Sepsis Criteria with procalcitonin (PCT) as a tool for predicting mortality in children with sepsis. Methods This retrospective study analyzed 192 pediatric patients with sepsis aged 1 month to 18 years from August 2023 at Pediatric Intensive Care Unit (PICU) of Dr. Hasan Sadikin General Hospital, Bandung. Data on patient characteristics, Phoenix sepsis score, and PCT level were collected. Results The study showed a mortality rate was 54.7% within 28 days. Both the Phoenix Sepsis Criteria and PCT levels were significantly higher in the deceased patients ( p < 0.001). The Phoenix sepsis criteria showed better discriminatory performance compared with PCT, with an area under the curve (AUC) of 0.848 versus 0.689. A Phoenix sepsis score > 4 was associated with an OR of 9.30, whereas a PCT level > 13.42 ug/L predictive power was considerably lower, with an OR of 3.00. According to the linear regression analysis, procalcitonin levels increased multiplicatively threefold for every one-point increase in the Phoenix sepsis score. Conclusion The Phoenix Sepsis Criteria showed stronger statistical performance for predicting mortality in pediatric sepsis patients compared to PCT. Its implementation in clinical practice may improve timely and effective identification of high-risk patients.