A comparative analysis of Phoenix, PELOD-2, and pSOFA scores to predict mortality in children with clinical sepsis

Background. Sepsis causes significant morbidity and mortality in children worldwide, despite the development of standardized treatment guidelines, vaccination programs, and advanced techniques for organ support in intensive care. Early mortality prediction is crucial for optimizing care, targeting interventions according to risk, and ultimately reducing mortality. Several scoring systems are used to predict outcomes and mortality for pediatric patients with sepsis, but how they compare in terms of sensitivity and specificity is unclear. This study compares the Phoenix, Pediatric Sequential Organ Failure Assessment (pSOFA), and Pediatric Logistic Organ Dysfunction (PELOD)-2 scores in predicting mortality in children with clinical sepsis. Method. This retrospective cohort study was conducted at Dr. Cipto Mangunkusumo General Hospital, Jakarta, from January to April 2018. The primary outcome was early pediatric intensive care unit mortality (within 7 days). All data were analyzed using STATA 17 and MedCal12. The area under the receiver operatinc characteristics (AUROC) curves of the Phoenix, pSOFA, and PELOD-2 scores were compared using DeLong’s test. Results. A total of 69 patients were clinically diagnosed with sepsis and 26.1% died. ROC curve analysis showed that the AUROCs of pSOFA, Phoenix, and PELOD-2 for predicting mortality were 0.745, 0.741, and 0.682, respectively. At their respective cutoffs, the pSOFA, Phoenix, and PELOD-2 scores had sensitivities for mortality prediction of 72.2%, 83.3%, and 72.2%, respectively, and specificities of 64.7%, 62.75%, and 54.90%. Conclusions. The pSOFA and Phoenix scores demonstrated better performance in predicting mortality in children with clinical sepsis than the PELOD-2 score. When selecting an appropriate scoring system, factors such as simplicity and local conditions must be considered to ensure optimal performance.