What is the clinical evidence from this study?

Study design: Cohort. Population: Pediatric intensive care unit (PICU) admission (n=1440). Intervention: pSOFA score vs. PRISM 4 and PIM 3 scores. Primary outcome: PICU mortality (AUC 0.807).

What does this research mean for the field?

The age-adapted pSOFA score demonstrates good discrimination for pediatric intensive care unit mortality, performing comparably to PIM 3 but with lower discrimination than PRISM 4. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the performance of the age-adapted Pediatric Sequential Organ Failure Assessment (pSOFA) score for predicting mortality in a pediatric intensive care unit and compare it against PRISM 4 and PIM 3.

September 28, 2026HealthcareOpen Access

Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3

Q: What are the key findings of this study?

The pSOFA score demonstrated good discrimination for PICU mortality (AUC 0.807), whereas PRISM 4 (AUC 0.847) showed significantly greater discrimination.

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Key result

PRISM 4 provides greater discrimination for PICU mortality than pSOFA.

AUC 0.807
n=1,440

Authors

FSFerhat SarıIstanbul Aydın University GCGökhan CeylanDr. Behçet Uz Çocuk Hastalıkları Hastanesi OSOzlem SaracDr. Behçet Uz Çocuk Hastalıkları Hastanesi

Discussion

Member takes

Implication

Requires heightened clinical awareness in comparable cohorts; leaves open the role of specific interventions pending prospective validation.

Key Points

To evaluate the performance of the age-adapted Pediatric Sequential Organ Failure Assessment (pSOFA) score for predicting mortality in a pediatric intensive care unit and compare it against PRISM 4 and PIM 3.
Single-center, retrospective study analyzing 1440 eligible admissions to a tertiary pediatric intensive care unit.
pSOFA, PRISM 4, and PIM 3 scores were retrospectively calculated and assessed for discrimination and calibration.
Overall mortality was 13.1%, with non-survivors exhibiting significantly higher median pSOFA scores than survivors [6 (IQR 4–10) vs. 3 (IQR 2–4), p < 0.001].
Discriminative performance for mortality was 0.807 for pSOFA, 0.847 for PRISM 4, and 0.781 for PIM 3; PRISM 4 showed significantly higher discrimination than pSOFA, while pSOFA and PIM 3 did not differ significantly.
PRISM 4 and PIM 3 demonstrated miscalibration, with observed mortality exceeding mean predicted mortality across the cohort.

Study Design

Type

Cohort (n=1,440)

Multicenter

PICO

Population

1,440 pediatric intensive care unit admissions evaluated retrospectively to compare mortality prediction scores.

Exposure / Comparator

pSOFA score vs PRISM 4 and PIM 3 scores

Primary Outcome

PICU mortality — AUC 0.807

Main Result

Effect estimate: AUC 0.807

Limitations

Single-center retrospective design

Cite This Study

Sarı et al. (2026) conducted a cohort in Pediatric intensive care unit (PICU) admission (n=1,440). pSOFA score vs. PRISM 4 and PIM 3 scores was evaluated on PICU mortality (AUC 0.807). The pSOFA score demonstrated good discrimination for PICU mortality (AUC 0.807), whereas PRISM 4 (AUC 0.847) showed significantly greater discrimination.

synapsesocial.com/papers/6ab9b43c7822ec8fc3d8db04 https://doi.org/10.3390/healthcare14193162

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Implication

Requires heightened clinical awareness in comparable cohorts; leaves open the role of specific interventions pending prospective validation.

Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Limitations

Cite This Study

Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider