Publication:

Paediatric assessment score as predictor of mortality in pediatric intensive care units

Background To study paediatric assessment score (pSOFA) as predictor of mortality in PICU.

Methods This prospective study is conducted in children of age group one month to 12 yrs, who were admitted in the PICU of a tertiary care hospital, G.G Hospital, Jamnagar in 1 year time period of around 150 patients. The variables include SpO2: FiO2 ratio, platelet counts, Total S. bilirubin (mg/dl), mean blood pressure by age group with use of vasoactive, Glasgow Coma Scale and S. creatinine (mg/dl). Observed values were noted in case record form, scores were given for individual components according to p-SOFA score assessment chart. A total score was calculated for each patient.

Results The use of a scoring system and audit of ICUs has not been widely reported in India. In our study, The pSOFA score demonstrated good performance in predicting mortality, with an area under the ROC curve of 0.86 (95% CI: 0.79-0.93). A score ≥6 had a sensitivity of 84.6%, specificity of 69.4%, positive predictive value of 50.7% and negative predictive value of 92.2% for mortality.

Conclusions Pediatric SOFA score (pSOFA) score can be used as a reliable prognostic predictor of mortality among PICU patients. pSOFA score provides an objective assessment of severity of illness. Earlier assessment of disease severity based on pSOFA score helps in vigorous management and better patient treatment, which helps in patient survival.  Factors such as need for mechanical ventilation and inotrope use were significantly associated with mortality.