{"title":"Phoenix脓毒症评分标准在重症儿童中的应用：2019-2024年中国回顾性单中心PICU队列评估","authors":"Jiaqian Fan, Haoran Shen, Lvchang Zhu, Zehua Wu, Sheng Ye, Qiang Shu, Qixing Chen","doi":"10.1097/PCC.0000000000003833","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the Phoenix Sepsis Score (PSS) and criteria in PICU children with suspected or confirmed infection. Additionally, to assess PSS performance in relation to in-hospital mortality.</p><p><strong>Design: </strong>Retrospective data from a 2019-2024 cohort.</p><p><strong>Setting: </strong>Single-center, multidisciplinary, tertiary PICU in China.</p><p><strong>Patients: </strong>In 2584 patient encounters, 0-18 years old, there were 2396 separate encounters with suspected or confirmed infection.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>The PSS was calculated as the sum of four organ subscores (respiratory, cardiovascular, neurologic, and coagulation) using the worst post-admission data from the first 24 hours. Sepsis was defined as a PSS greater than or equal to 2 points and septic shock as sepsis with greater than or equal to 1 point in the cardiovascular subscore. In 2396 patient encounters with suspected or confirmed infection, 1261 (52.6%) with sepsis had a 19.9% (251/1261) mortality rate, and 573/1261 (45.4%) with septic shock had a 34.9% (200/573) mortality rate. Nonsurvival vs. survival was associated with higher median (interquartile range [IQR]) PSS (5 points [IQR, 3-7 points] vs. 2 points [IQR, 2-3 points]; p < 0.001). Also, in-hospital mortality rate increased with progressively higher PSS points. A PSS greater than or equal to 2 points had an area under the receiver operating characteristic curve of 0.81 (95% CI, 0.78-0.84) for in-hospital mortality. Comparison with the International Pediatric Sepsis Consensus Conference (IPSCC) criteria or the pediatric Sequential Organ Failure Assessment (pSOFA) score showed that the PSS had better performance in identifying death rate for those patients with sepsis and for those with septic shock.</p><p><strong>Conclusions: </strong>In our single-center PICU cohort (2019-2024) from China, among patient encounters with suspected or confirmed infection, the PSS showed good discriminatory ability in identifying sepsis or septic shock. It also outperformed the IPSCC criteria and the pSOFA score in classifying in-hospital mortality. These analyses support the potential utility of the PSS for risk stratification in our international PICU setting.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Phoenix Sepsis Score Criteria in Critically Ill Children: Evaluation Using a Retrospective, Single-Center PICU Cohort in China, 2019-2024.\",\"authors\":\"Jiaqian Fan, Haoran Shen, Lvchang Zhu, Zehua Wu, Sheng Ye, Qiang Shu, Qixing Chen\",\"doi\":\"10.1097/PCC.0000000000003833\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the Phoenix Sepsis Score (PSS) and criteria in PICU children with suspected or confirmed infection. Additionally, to assess PSS performance in relation to in-hospital mortality.</p><p><strong>Design: </strong>Retrospective data from a 2019-2024 cohort.</p><p><strong>Setting: </strong>Single-center, multidisciplinary, tertiary PICU in China.</p><p><strong>Patients: </strong>In 2584 patient encounters, 0-18 years old, there were 2396 separate encounters with suspected or confirmed infection.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>The PSS was calculated as the sum of four organ subscores (respiratory, cardiovascular, neurologic, and coagulation) using the worst post-admission data from the first 24 hours. Sepsis was defined as a PSS greater than or equal to 2 points and septic shock as sepsis with greater than or equal to 1 point in the cardiovascular subscore. In 2396 patient encounters with suspected or confirmed infection, 1261 (52.6%) with sepsis had a 19.9% (251/1261) mortality rate, and 573/1261 (45.4%) with septic shock had a 34.9% (200/573) mortality rate. Nonsurvival vs. survival was associated with higher median (interquartile range [IQR]) PSS (5 points [IQR, 3-7 points] vs. 2 points [IQR, 2-3 points]; p < 0.001). Also, in-hospital mortality rate increased with progressively higher PSS points. A PSS greater than or equal to 2 points had an area under the receiver operating characteristic curve of 0.81 (95% CI, 0.78-0.84) for in-hospital mortality. Comparison with the International Pediatric Sepsis Consensus Conference (IPSCC) criteria or the pediatric Sequential Organ Failure Assessment (pSOFA) score showed that the PSS had better performance in identifying death rate for those patients with sepsis and for those with septic shock.</p><p><strong>Conclusions: </strong>In our single-center PICU cohort (2019-2024) from China, among patient encounters with suspected or confirmed infection, the PSS showed good discriminatory ability in identifying sepsis or septic shock. It also outperformed the IPSCC criteria and the pSOFA score in classifying in-hospital mortality. These analyses support the potential utility of the PSS for risk stratification in our international PICU setting.</p>\",\"PeriodicalId\":19760,\"journal\":{\"name\":\"Pediatric Critical Care Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Critical Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PCC.0000000000003833\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Critical Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PCC.0000000000003833","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
The Phoenix Sepsis Score Criteria in Critically Ill Children: Evaluation Using a Retrospective, Single-Center PICU Cohort in China, 2019-2024.
Objectives: To evaluate the Phoenix Sepsis Score (PSS) and criteria in PICU children with suspected or confirmed infection. Additionally, to assess PSS performance in relation to in-hospital mortality.
Design: Retrospective data from a 2019-2024 cohort.
Setting: Single-center, multidisciplinary, tertiary PICU in China.
Patients: In 2584 patient encounters, 0-18 years old, there were 2396 separate encounters with suspected or confirmed infection.
Interventions: None.
Measurements and main results: The PSS was calculated as the sum of four organ subscores (respiratory, cardiovascular, neurologic, and coagulation) using the worst post-admission data from the first 24 hours. Sepsis was defined as a PSS greater than or equal to 2 points and septic shock as sepsis with greater than or equal to 1 point in the cardiovascular subscore. In 2396 patient encounters with suspected or confirmed infection, 1261 (52.6%) with sepsis had a 19.9% (251/1261) mortality rate, and 573/1261 (45.4%) with septic shock had a 34.9% (200/573) mortality rate. Nonsurvival vs. survival was associated with higher median (interquartile range [IQR]) PSS (5 points [IQR, 3-7 points] vs. 2 points [IQR, 2-3 points]; p < 0.001). Also, in-hospital mortality rate increased with progressively higher PSS points. A PSS greater than or equal to 2 points had an area under the receiver operating characteristic curve of 0.81 (95% CI, 0.78-0.84) for in-hospital mortality. Comparison with the International Pediatric Sepsis Consensus Conference (IPSCC) criteria or the pediatric Sequential Organ Failure Assessment (pSOFA) score showed that the PSS had better performance in identifying death rate for those patients with sepsis and for those with septic shock.
Conclusions: In our single-center PICU cohort (2019-2024) from China, among patient encounters with suspected or confirmed infection, the PSS showed good discriminatory ability in identifying sepsis or septic shock. It also outperformed the IPSCC criteria and the pSOFA score in classifying in-hospital mortality. These analyses support the potential utility of the PSS for risk stratification in our international PICU setting.
期刊介绍：
Pediatric Critical Care Medicine is written for the entire critical care team: pediatricians, neonatologists, respiratory therapists, nurses, and others who deal with pediatric patients who are critically ill or injured. International in scope, with editorial board members and contributors from around the world, the Journal includes a full range of scientific content, including clinical articles, scientific investigations, solicited reviews, and abstracts from pediatric critical care meetings. Additionally, the Journal includes abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese, and Spanish translations - making news of advances in the field available to pediatric and neonatal intensive care practitioners worldwide.
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