Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3.
8 affiliations
- 1Pediatric Intensive Care Unit, Bezmialem Vakif University, Fatih, Istanbul 34093, Turkey.
- 2Research and New Technology Department, Hamilton Medical AG, 7402 Bonaduz, Switzerland.
- 3Pediatric Intensive Care Unit, Dr. Behcet Uz Children's Hospital, University of Health Sciences, Izmir 35210, Turkey.
- 4Pediatric Intensive Care Unit, Acibadem Altunizade Hospital, Acibadem University, Istanbul 34662, Turkey.
- 5Pediatric Intensive Care Unit, Cam Sakura Research and Training Hospital, University of Health Sciences, Istanbul 34480, Turkey.
- 6Pediatric Intensive Care Unit, Aydin Maternity and Children's Hospital, Aydın 09020, Turkey.
- 7Division of Otolaryngology, Department of Surgery, Denver Health Medical Center, Denver, CO 80204, USA.
- 8Neuroscience Doctoral Program, Yeditepe University, Istanbul 34755, Turkey.
Abstract
Objectives: We aimed to evaluate the performance of the age-adapted Pediatric Sequential Organ Failure Assessment (pSOFA) score, as a predictor of mortality in patients admitted to pediatric intensive care units (PICUs), and to compare it with the Pediatric Risk of Mortality 4 (PRISM 4) and Pediatric Index of Mortality 3 (PIM 3) scores. Methods: This single-center, retrospective study analyzed data from 1440 eligible PICU admissions to a tertiary PICU. The pSOFA, PRISM 4, and PIM 3 scores were calculated retrospectively for each patient. Results: The overall mortality was 13.1%, and the median length of stay was 11 days. The median (IQR) pSOFA score was significantly higher in non-survivors than in survivors [6 (4-10) vs. 3 (2-4), p < 0.001]. Mortality increased significantly with increasing pSOFA scores (p < 0.001). The area under the receiver operating characteristic curve (AUC) values for pSOFA, PRISM 4, and PIM 3 were 0.807, 0.847, and 0.781, respectively. The pSOFA score exhibited a significant positive correlation with both PRISM 4 and PIM 3 (p < 0.001). PRISM 4 and PIM 3 demonstrated evidence of miscalibration in this cohort, with observed mortality exceeding mean predicted mortality for both models. Conclusions: pSOFA demonstrated good discrimination for PICU mortality and a strong association with mortality in this single-center retrospective cohort. PRISM 4 showed significantly greater discrimination than pSOFA, whereas pSOFA and PIM 3 did not differ significantly. These findings support further prospective multicenter evaluation before broader clinical implementation.
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BibTeX
@article{sarı2026evaluation,
title = {{Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3.}},
author = {Ferhat Sarı and Gokhan Ceylan and Ozlem Sarac and Gulhan Atakul and Sevgi Topal and Mustafa Colak and Ekin Soydan and Hasan Agin and Aynur Aliyeva},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/healthcare14193162},
url = {https://europepmc.org/article/MED/42881601},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluation of the pSOFA Score in a Pediatric Intensive Care Unit and Its Discriminative Performance Compared with PRISM 4 and PIM 3.
AU - Ferhat Sarı
AU - Gokhan Ceylan
AU - Ozlem Sarac
AU - Gulhan Atakul
AU - Sevgi Topal
AU - Mustafa Colak
AU - Ekin Soydan
AU - Hasan Agin
AU - Aynur Aliyeva
PY - 2026
DA - 2026/09/24
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193162
UR - https://europepmc.org/article/MED/42881601
AB - Objectives: We aimed to evaluate the performance of the age-adapted Pediatric Sequential Organ Failure Assessment (pSOFA) score, as a predictor of mortality in patients admitted to pediatric intensive care units (PICUs), and to compare it with the Pediatric Risk of Mortality 4 (PRISM 4) and Pediatric Index of Mortality 3 (PIM 3) scores. Methods: This single-center, retrospective study analyzed data from 1440 eligible PICU admissions to a tertiary PICU. The pSOFA, PRISM 4, and PIM 3 scores were calculated retrospectively for each patient. Results: The overall mortality was 13.1%, and the median length of stay was 11 days. The median (IQR) pSOFA score was significantly higher in non-survivors than in survivors [6 (4-10) vs. 3 (2-4), p < 0.001]. Mortality increased significantly with increasing pSOFA scores (p < 0.001). The area under the receiver operating characteristic curve (AUC) values for pSOFA, PRISM 4, and PIM 3 were 0.807, 0.847, and 0.781, respectively. The pSOFA score exhibited a significant positive correlation with both PRISM 4 and PIM 3 (p < 0.001). PRISM 4 and PIM 3 demonstrated evidence of miscalibration in this cohort, with observed mortality exceeding mean predicted mortality for both models. Conclusions: pSOFA demonstrated good discrimination for PICU mortality and a strong association with mortality in this single-center retrospective cohort. PRISM 4 showed significantly greater discrimination than pSOFA, whereas pSOFA and PIM 3 did not differ significantly. These findings support further prospective multicenter evaluation before broader clinical implementation.
SN - 2227-9032
ER -