World journal of pediatrics : WJP · 2026
Discrimination performance of the Phoenix sepsis score versus pediatric sequential organ failure assessment for predicting in-hospital mortality in critically ill children: a multicenter external validation study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ru Xuan-Wen, Liu Rui-Ying, Yang Zi-Hao, Huang Cai-Zhi, Zhang Cong, Li Tie-Wei, Yang Jun-Mei, Liu Yang, Cui Xiao-Yu, Chen Hong-Bing, Zhou Xun, Tang Feng, Gong Xu-Yang, Ling Ping, Lv Xin, Zeng Qian, Ma Zhan, Yuan Bao-Yu, Zhu Hong, Shao Xue-Jun, Wu Jing, Yu Rui-Jie, Zhang Xiao-Wei, Wang Jing-Ran, Cheng Feng, Huang Su-Hong, Chi Kun, Liu Guo-Feng, Zhou Zhen-Wen, Liu Xiao-Chun, Yan Wei-Li, Qi Guo-Qiang, Shao Wen-Xia, Ye Qing
Аннотация
BACKGROUND: This study compared the prognostic accuracy of the Phoenix sepsis score (PSS) and the pediatric sequential organ failure assessment (pSOFA) score for predicting in-hospital mortality in critically ill children with suspected infection, with a focus on neonatal and hematology sub-cohorts.
METHODS: This retrospective, multicenter cohort study analyzed data from 2374 children (< 18 years) with suspected infections admitted to 13 intensive care units (ICUs) between 2023 and 2025. Two predefined sub-cohorts were examined: the neonatal sub-cohort (≤ 28 days; n = 576) and the hematology sub-cohort (n = 494). PSS and pSOFA scores were calculated using the worst available physiological and laboratory data within 24 hours of ICU admission. The primary outcome was in-hospital mortality. Prognostic accuracy was assessed mainly via the adjusted area under the receiver operating characteristic curve (AUROC).
RESULTS: Compared with the pSOFA score, the PSS demonstrated significantly greater discrimination for mortality (adjusted AUROC: 0.840 vs. 0.817; P < 0.001) in the overall cohort (n = 2374) and the hematology sub-cohort (0.718 vs. 0.682; P = 0.006) but not in neonates (0.915 vs. 0.850; P = 0.222). At the ≥ 2-point threshold, both scores maintained high sensitivity (> 80%) but low positive predictive value (PPV) (≤ 50%) across all cohorts. In the high-event-rate hematology sub-cohort, the PSS had an approximately 5% lower sensitivity for a meaningfully higher PPV than the pSOFA score. In contrast, within the low-event-rate neonatal sub-cohort, both tools showed equivalent sensitivity and similarly low PPVs (< 8%).
CONCLUSIONS: In this study, the PSS demonstrated superior predictive performance in the overall cohort, whereas no statistically significant difference was observed between the two scores in the neonatal sub-cohort. In the hematology sub-cohort, both scores showed limited discriminative ability.
METHODS: This retrospective, multicenter cohort study analyzed data from 2374 children (< 18 years) with suspected infections admitted to 13 intensive care units (ICUs) between 2023 and 2025. Two predefined sub-cohorts were examined: the neonatal sub-cohort (≤ 28 days; n = 576) and the hematology sub-cohort (n = 494). PSS and pSOFA scores were calculated using the worst available physiological and laboratory data within 24 hours of ICU admission. The primary outcome was in-hospital mortality. Prognostic accuracy was assessed mainly via the adjusted area under the receiver operating characteristic curve (AUROC).
RESULTS: Compared with the pSOFA score, the PSS demonstrated significantly greater discrimination for mortality (adjusted AUROC: 0.840 vs. 0.817; P < 0.001) in the overall cohort (n = 2374) and the hematology sub-cohort (0.718 vs. 0.682; P = 0.006) but not in neonates (0.915 vs. 0.850; P = 0.222). At the ≥ 2-point threshold, both scores maintained high sensitivity (> 80%) but low positive predictive value (PPV) (≤ 50%) across all cohorts. In the high-event-rate hematology sub-cohort, the PSS had an approximately 5% lower sensitivity for a meaningfully higher PPV than the pSOFA score. In contrast, within the low-event-rate neonatal sub-cohort, both tools showed equivalent sensitivity and similarly low PPVs (< 8%).
CONCLUSIONS: In this study, the PSS demonstrated superior predictive performance in the overall cohort, whereas no statistically significant difference was observed between the two scores in the neonatal sub-cohort. In the hematology sub-cohort, both scores showed limited discriminative ability.