What question did this study set out to answer?

To evaluate and compare the diagnostic accuracy of the Pediatric Sequential Organ Failure Assessment (p-SOFA) and Pediatric Risk of Mortality III (PRISM III) scores for predicting 30-day mortality in critically ill pediatric patients.

January 9, 2022CureusOpen Access

Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Mortality Prediction in Pediatric Intensive Care Unit

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Critically ill children (n=286). Intervention: Pediatric Sequential Organ Failure Assessment (p-SOFA) vs. Pediatric Risk of Mortality (PRISM) III score. Primary outcome: 30-day mortality prediction (Area Under the Curve) (AUC 0.81, 95% CI 0.76-0.86, p=0.001).

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Key result

p-SOFA predicts 30-day PICU mortality with an AUC of 0.81, outperforming PRISM III 24.

AUC 0.81
95% CI 0.76-0.86
P=0.001
n=286

Why the study?

To assess and compare the diagnostic accuracy of the PRISM III score and p-SOFA for predicting mortality in critically ill children.

Does the p-SOFA score provide better diagnostic accuracy than the PRISM III score for predicting 30-day mortality in critically ill children?

Comparison

p-SOFA score vs PRISM III 24 score

Design

Cross-validation study

Follow-up

30 days

Authors

SBSadam H BalochNational Institute of Child Health ISIkramullah ShaikhNational Institute of Child Health MGMurtaza Ali GowaNational Institute of Child Health

Discussion

Member takes

Implication

p-SOFA may improve mortality prediction in PICU children; hypothesis-generating and requires prospective validation before adoption.

Key Points

To evaluate and compare the diagnostic accuracy of the Pediatric Sequential Organ Failure Assessment (p-SOFA) and Pediatric Risk of Mortality III (PRISM III) scores for predicting 30-day mortality in critically ill pediatric patients.
Cross-validation study conducted at the National Institute of Child Health Karachi from February 2021 to July 2021.
Enrolled 286 critically ill children aged 1 month to 15 years admitted to the PICU for more than 24 hours.
Calculated p-SOFA and PRISM III 24 scores within 24 hours of admission to assess 30-day mortality.
Overall 30-day mortality was 57%, with both scoring systems showing significantly higher values among non-survivors.
Maximum p-SOFA showed strong discrimination for 30-day mortality (AUC=0.81, 95% CI=0.76-0.86, p=0.001) compared to PRISM III 24 (AUC=0.75, 95% CI=0.69-0.81, p=0.001).
At a cut-off >2, p-SOFA demonstrated 93.87% sensitivity, 38.21% specificity, and 69.93% accuracy, while PRISM III 24 >8 demonstrated 55.83% sensitivity, 77.24% specificity, and 65.03% accuracy.

Study Design

Type

Cross-Sectional (n=286)

Multicenter

Structured PICO

Does the p-SOFA score provide better diagnostic accuracy than the PRISM III score for predicting 30-day mortality in critically ill children?

Population

286 critically ill children aged 1 to 144 months admitted to a pediatric intensive care unit for more than 24 hours, evaluated for 30-day mortality.

Exposure

Pediatric Sequential Organ Failure Assessment (p-SOFA) score

Comparator

Pediatric Risk of Mortality (PRISM) III 24 score

Outcome

Mortality within 30 days of PICU admissionhard clinical

Main Result

Effect estimate: AUC 0.81 (95% CI 0.76-0.86)

Absolute Event Rate: 0.81% vs 0.75%

p-value: p=0.001

The p-SOFA score is a more accurate predictor of 30-day mortality than the PRISM III score in critically ill children admitted to the PICU.

Limitations

Data was collected from a single pediatric intensive care unit.
Relatively small sample size compared to other validation studies.

Cite This Study

Baloch et al. (2022) conducted a cross-sectional in Critically ill children (n=286). Pediatric Sequential Organ Failure Assessment (p-SOFA) vs. Pediatric Risk of Mortality (PRISM) III score was evaluated on 30-day mortality prediction (Area Under the Curve) (AUC 0.81, 95% CI 0.76-0.86, p=0.001). The p-SOFA score demonstrated good discrimination for 30-day mortality in critically ill children with an AUC of 0.81, showing better accuracy than the PRISM III 24 score.

synapsesocial.com/papers/6aa439f7aaaedccdac74ab4d https://doi.org/10.7759/cureus.21055

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Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Mortality Prediction in Pediatric Intensive Care Unit

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Mortality Prediction in Pediatric Intensive Care Unit

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider