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Objectives <p>To evaluate the prognostic accuracy of serially measured PEdiatric Logistic Organ Dysfunction (PELOD)-2 and pediatric Sequential Organ Failure Assessment (pSOFA) scores for predicting 28-day in-hospital mortality in pediatric fluid-refractory septic shock.</p> Methods <p>Children aged &lt; 12&#xa0;years admitted to the pediatric intensive care unit (PICU) with fluid-refractory septic shock were enrolled. PELOD-2 and age-adapted pSOFA scores were compared using crude and adjusted area under the receiver operating characteristic curve (AUROC) analysis over the first four days of PICU admission.</p> Results <p>Of the 93 children analyzed, 38 (40.9%) died, and 45 (48.4%) experienced a PICU length of stay ≥ 7&#xa0;days. The sensitivity of PELOD-2 (score ≥ 8) to predict 28-day in-hospital mortality increased from 60.5 on day 1 to 84.2% on day 4, whereas that of pSOFA (score ≥ 8) increased from 47.4 to 63.2%. Discriminative power improved over time, with adjusted AUROC for mortality prediction increasing from day 1 to day 4 for both PELOD-2 (0.69&#xa0;to&#xa0;0.90) and pSOFA (0.69&#xa0;to&#xa0;0.88).</p> Conclusions <p>In children with fluid-refractory septic shock, PELOD-2 and pSOFA scores demonstrated increasing prognostic accuracy for 28-day in-hospital mortality when assessed serially, with better discrimination on day 4 compared with baseline scores at admission.</p>

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Prognostic Accuracy of Serially Measured Organ Dysfunction Scores in Children with Fluid Refractory Septic Shock

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Ritu Sharma,
  • Arpita Chattopadhyay,
  • Diganta Saikia,
  • Nehal Singhal,
  • Alisha Austin Crasto,
  • Mimansa Sharma

摘要

Objectives

To evaluate the prognostic accuracy of serially measured PEdiatric Logistic Organ Dysfunction (PELOD)-2 and pediatric Sequential Organ Failure Assessment (pSOFA) scores for predicting 28-day in-hospital mortality in pediatric fluid-refractory septic shock.

Methods

Children aged < 12 years admitted to the pediatric intensive care unit (PICU) with fluid-refractory septic shock were enrolled. PELOD-2 and age-adapted pSOFA scores were compared using crude and adjusted area under the receiver operating characteristic curve (AUROC) analysis over the first four days of PICU admission.

Results

Of the 93 children analyzed, 38 (40.9%) died, and 45 (48.4%) experienced a PICU length of stay ≥ 7 days. The sensitivity of PELOD-2 (score ≥ 8) to predict 28-day in-hospital mortality increased from 60.5 on day 1 to 84.2% on day 4, whereas that of pSOFA (score ≥ 8) increased from 47.4 to 63.2%. Discriminative power improved over time, with adjusted AUROC for mortality prediction increasing from day 1 to day 4 for both PELOD-2 (0.69 to 0.90) and pSOFA (0.69 to 0.88).

Conclusions

In children with fluid-refractory septic shock, PELOD-2 and pSOFA scores demonstrated increasing prognostic accuracy for 28-day in-hospital mortality when assessed serially, with better discrimination on day 4 compared with baseline scores at admission.