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Published on: February 7, 2025
Utility of Phoenix Sepsis Score for Predicting Mortality in Pediatric Sepsis: A Prospective Analytical Study from a
Rakesh Kumar1, Arindam Ghosh2, Saba Annigeri1
1Department of Paediatrics, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Background And Aims:
Sepsis remains a leading cause of pediatric in-hospital mortality, particularly in resource-limited settings. The Pediatric Sequential Organ Failure Assessment (p-SOFA) score is widely used to guide prognostication, but its performance in children is suboptimal. The Phoenix Sepsis Score (PSS), developed specifically for pediatric patients, may offer improved predictive accuracy, yet validation data from Eastern India are lacking. We aimed to evaluate and compare the predictive performance of the PSS and p-SOFA scores for in-hospital mortality among children with sepsis admitted to a resource-limited pediatric intensive care unit (PICU) in Eastern India.
Patients And Methods:
This prospective analytical study enrolled children aged 1 month to 15 years with suspected or confirmed sepsis over 18 months. The PSS and p-SOFA scores were recorded on day 1 and day 3. Predictive performance for in-hospital mortality was assessed using the areas under the receiver-operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), sensitivity, specificity, positive predictive value, and negative predictive value. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR) for mortality.
Results:
Among 105 included children, 21 (20%) died during hospital stay. Non-survivors had significantly higher PSS and p-SOFA scores on both day 1 and day 3 (p < 0.001). On day 3, the PSS showed superior predictive performance (AUROC 0.910; AUPRC 0.678) compared to p-SOFA (AUROC 0.861; AUPRC 0.595). A PSS ≥5 on day 3 was associated with 96% sensitivity and significantly increased odds of in-hospital mortality (aOR 40.0, 95% CI: 35.1-47.5).
Conclusion:
Both scores are effective for mortality prediction, but the PSS demonstrated superior sensitivity, ease of use, and robustness in resource-limited environments. The PSS may serve as a more practical tool for early prognostication in pediatric sepsis.
How To Cite This Article:
Kumar R, Ghosh A, Annigeri S, Prakash J, Jana D. Utility of Phoenix Sepsis Score for Predicting Mortality in Pediatric Sepsis: A Prospective Analytical Study from a Resource-limited Pediatric Intensive Care Unit in Eastern India. Indian J Crit Care Med 2026;30(1):27-34.
