Comparative analysis of the information value of the pSOFA, Phoenix-4 and Phoenix-8 scores in sepsis in children

Introduction . In the diagnosis and treatment of sepsis in children, a comparative analysis of various tools for assessing the severity of organ dysfunction is extremely important. The objective was to compare the discriminatory ability of the Phoenix-4, Phoenix-8 and pSOFA organ dysfunction severity scales in pediatric sepsis. Materials and methods . The study design is retrospective, observational, single-center. The diagnosis of sepsis and shock was carried out on the basis of Russian recommendations for the diagnosis and treatment of sepsis in children. 97 patients were examined. Septic shock was diagnosed in 26 (26.8%) patients, 19 (19.6%) children died. The endpoint of the study is 28-day mortality. The most common cause of sepsis was pneumonia, which was detected in 82 (84.5%) children. Statistical processing was performed using MedCalc® Statistical Software ( www.medcalc.org ). Results . It was found that in children with sepsis, the informational value of the Phoenix-4, Phoenix-8 and pSOFA scales is comparable. In the presence of renal dysfunction in the structure of multiple organ failure, the risk of death increases significantly. Moderate discriminatory ability is inherent in the Phoenix Score Sepsis 8 and pSOFA scales; the information value of the PSS-8 system significantly exceeds the capabilities of the pSOFA scale (AUG ROC 0.676 versus 0.607; p < 0.05). Almost all children (21 of 23) with kidney dysfunction had clinical laboratory signs of shock. Conclusion . The discriminatory ability of the Phoenix Score Sepsis 4 and Phoenix Score Sepsis 8 scales in pediatric sepsis has no significant differences, however, the Phoenix Score Sepsis 8 rating system has advantages over the Phoenix Score Sepsis 4 scale and pSOFA in assessing clinical outcomes septic shock.