Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Prediction in Pediatric Intensive Care Unit
DOI:
https://doi.org/10.70749/ijbr.v3i4.2978Keywords:
Pediatric Intensive Care Unit, PRISM III Score, pSOFA Score, Mortality Prediction, Critically Ill Children.Abstract
Objective: To compare the predictive accuracy of Pediatric Sequential Organ Failure Assessment (pSOFA) and Pediatric Risk of Mortality III (PRISM III) scores for mortality prediction in children admitted to the pediatric intensive care unit. Study Design: Prospective longitudinal study. Place and Duration of Study: Pediatric Intensive Care Unit, Abbasi Shaheed Hospital, Karachi, from June 2024 to January 2025. Methodology: A total of 207 critically ill children aged between 1 month and 12 years who remained in the PICU for at least 24 hours were enrolled using non-probability consecutive sampling. PRISM III and pSOFA scores were calculated within the first 24 hours of PICU admission. Patients were followed until discharge from the PICU, and 30-day mortality was recorded as the primary outcome. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated for both scoring systems. Results: The mean age of the patients was 4.9 ± 3.6 years and 118 (57.0%) were males. Overall mortality was observed in 43 (20.8%) patients. The mean PRISM III score was significantly higher in non-survivors compared with survivors (19.7 ± 6.3 vs. 11.2 ± 4.6). Similarly, the mean pSOFA score was higher among non-survivors compared with survivors (9.6 ± 3.1 vs. 5.1 ± 2.2). The pSOFA score demonstrated higher sensitivity (83.7%) and specificity (78.0%) compared with PRISM III (79.1% and 74.4%, respectively). The area under the receiver operating characteristic curve was 0.82 for pSOFA and 0.76 for PRISM III. Conclusion: Both PRISM III and pSOFA scores are useful tools for predicting mortality in critically ill children admitted to the PICU; however, pSOFA demonstrated better predictive performance. The pSOFA score may therefore serve as a practical and reliable scoring system for mortality prediction in pediatric intensive care settings.
Downloads
References
1. Maheshwari, N., & Agarwal, N. (2023). The role of pediatric sequential organ failure assessment lactate score in predicting the clinical outcome of critically ill children: A single-center, prospective, observational study. Journal of Pediatric Critical Care, 10(5), 193-198.
https://doi.org/10.4103/jpcc.jpcc_17_23
2. Qiu, J., Lu, X., Wang, K., Zhu, Y., Zuo, C., & Xiao, Z. (2017). Comparison of the pediatric risk of mortality, pediatric index of mortality, and pediatric index of mortality 2 models in a pediatric intensive care unit in China. Medicine, 96(14), e6431.
https://doi.org/10.1097/md.0000000000006431
3. Mohamed El-Mashad, G., Said El-Mekkawy, M., & Helmy Zayan, M. (2020). La escala pediátrica de evaluación del fallo multiorgánico secuencial (pSOFA): Una nueva escala de predicción de la mortalidad en la unidad de cuidados intensivos pediátricos. Anales de Pediatría, 92(5), 277-285.
https://doi.org/10.1016/j.anpedi.2019.05.018
4. Badke, C. M., Mayampurath, A., & Sanchez-Pinto, L. N. (2022). Multiple organ dysfunction interactions in critically ill children. Frontiers in Pediatrics, 10.
https://doi.org/10.3389/fped.2022.874282
5. Straney, L., Clements, A., Parslow, R. C., Pearson, G., Shann, F., Alexander, J., & Slater, A. (2013). Paediatric index of mortality 3. Pediatric Critical Care Medicine, 14(7), 673-681.
https://doi.org/10.1097/pcc.0b013e31829760cf
6. Pollack, M. M., Patel, K. M., & Ruttimann, U. E. (1996). Prism III. Critical Care Medicine, 24(5), 743-752.
https://doi.org/10.1097/00003246-199605000-00004
7. Albuali, W. H., Algamdi, A. A., Hasan, E. A., Al-Qahtani, M. H., Yousef, A. A., Al Ghamdi, M. A., Bubshait, D. K., Alshahrani, M. S., AlQurashi, F. O., Bou Shahmah, T. A., & Awary, B. H. (2020). Use of a mortality prediction model in children on mechanical ventilation: A 5-Year experience in a tertiary University Hospital. Journal of Multidisciplinary Healthcare, 13, 1507-1516.
https://doi.org/10.2147/jmdh.s282108
8. Singhal, D., Kumar, N., Puliyel, J. M., Singh, S. K., & Srinivas, V. (2001). Prediction of mortality by application of PRISM score in intensive care unit. Indian pediatrics, 38(7), 714-720.
https://www.indianpediatrics.net/july2001/july-714-719.htm?utm_medium=email&utm_source=transaction
9. Mirza, S., Malik, L., Ahmed, J., Malik, F., Sadiq, H., Ali, S., & Aziz, S. (2020). Accuracy of pediatric risk of mortality (PRISM) III score in predicting mortality outcomes in a pediatric intensive care unit in Karachi. Cureus.
https://doi.org/10.7759/cureus.7489
10. Costa, G. D., Delgado, A. F., Ferraro, A., & Okay, T. S. (2010). Application of the pediatric risk of mortality score (PRISM) score and determination of mortality risk factors in a tertiary pediatric intensive care unit. Clinics, 65(11), 1087-1092.
https://doi.org/10.1590/s1807-59322010001100005
11. Malik, A., Taksande, A., & Meshram, R. (2024). Pediatric sequential organ assessment score: A comprehensive review of the prognostic marker in the pediatric intensive care unit. Cureus.
https://doi.org/10.7759/cureus.60034
12. Baloch, S. H., Shaikh, I., Gowa, M. A., Lohano, P. D., & Ibrahim, M. N. (2022). Comparison of pediatric sequential organ failure assessment and pediatric risk of mortality III score as mortality prediction in pediatric intensive care unit. Cureus.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
