小児敗血症性ショックにおけるSOFAおよびPSSスコアの予後評価の比較：後向き研究
1Department of Pediatric Intensive Care Unit, Shanxi Children's Hospital, Shanxi Maternal and Child Health Hospital, Taiyuan, China.
Background:
Septic shock in pediatric intensive care units (PICUs) requires accurate prognostic tools. The Sequential Organ Failure Assessment (SOFA) and the Phoenix Sepsis Score (PSS) are both widely used, yet their comparative effectiveness has not been fully established.
Objectives:
To evaluate the prognostic sensitivity of the SOFA and PSS scores in predicting mortality among pediatric patients with septic shock, and to compare their performance across different patient subgroups.
Material And Methods:
This retrospective study included 110 pediatric patients with septic shock admitted to the PICU of Shanxi Children's Hospital between 2020 and 2024. SOFA and PSS scores were recorded at admission, along with demographic, clinical, and outcome data. Patients with congenital organ abnormalities or severe inherited metabolic disorders were excluded. Predictive accuracy was assessed using correlation analyses and receiver operating characteristic (ROC) curve analysis.
Results:
Both SOFA and PSS scores showed moderate correlations with mortality (SOFA: r = 0.57; PSS: r = 0.56), with SOFA demonstrating slightly higher overall predictive accuracy. PSS exhibited greater sensitivity in severe cases. Neurological and respiratory dysfunctions were the strongest predictors of mortality, whereas coagulation parameters had minimal prognostic value. Age-specific analysis revealed that SOFA was more accurate in patients aged 1-3 years and >7 years, while PSS outperformed SOFA in children aged 3-6 years.
Conclusions:
Both SOFA and PSS scores are effective tools for predicting mortality in pediatric septic shock. SOFA demonstrated superior overall performance, whereas PSS showed advantages in specific age ranges and disease categories. Using the two scoring systems in combination may support more informed clinical decision-making.
