Diagnostic Accuracy of pSOFA and qSOFA in Predicting Mortality among Children with Sepsis: A Cross-Sectional Observational Study

Abstract

Introduction: Sepsis, a life-threatening condition, continues to pose a substantial burden on healthcare systems worldwide. Prompt assessment of severity of illness at admission is crucial for initiating timely intervention and improving survival rates.

Objective: To evaluate the diagnostic accuracy of pSOFA and qSOFA in predicting mortality.

Methods: This was a single centre observational cross-sectional study conducted among children in the age group of 1 month to 15 years admitted to the Paediatric Intensive Care Unit (PICU) with sepsis (irrespective of the probable etiology; n = 50) between January 2023, and December 2023.

Results: The results showed that the non survivors had a significantly lower age (MD -26.9, 95% CI -40.4 to -13.4), higher pSOFA (MD 6.6, 95% CI 0.9 to 4.4), and qSOFA (MD 0.9, 95% CI 0.5 to 1.2) scores, in comparison with survivors (p<0.05). Receiver operating curve (ROC) analysis to predict mortality showed that the area under curve was significant for both pSOFA (0.979, 95% CI 0.928 to 1.000) and qSOFA (0.813, 95% CI 0.646 to 0.979) scores; however, AUC was higher for pSOFA. The sensitivity, specificity, PPV, and NPV were 100%, 41.7%, 22.2% and 100% for pSOFA; and 100%, 20.8%, 17.4%, and 100% qSOFA scores.

Conclusion: Our study underscores the critical importance of timely identification and risk stratification in paediatric patients with sepsis. Notably, the predictive ability of pSOFA scores (4 and above) appeared superior to that of qSOFA (2 and above).