• Luregn J Schlapbach, Sabrina Goertz, Niels Hagenbuch, Blandine Aubert, Sebastien Papis, Eric Giannoni, Klara M Posfay-Barbe, Martin Stocker, Ulrich Heininger, Sara Bernhard-Stirnemann, Anita Niederer-Loher, Christian R Kahlert, Giancarlo Natalucci, Christa Relly, Thomas Riedel, Christoph Aebi, Christoph Berger, Philipp K A Agyeman, and Swiss Pediatric Sepsis Study Group.
• Department of Intensive Care and Neonatology, and Children`s Research Center, University Children`s Hospital Zurich, Zurich, Switzerland.
• Pediatr Crit Care Me. 2024 Mar 1; 25 (3): e117e128e117-e128.

ObjectivesPrevious studies applying Sepsis-3 criteria to children were based on retrospective analyses of PICU cohorts. We aimed to compare organ dysfunction criteria in children with blood culture-proven sepsis, including emergency department, PICU, and ward patients, and to assess relevance of organ dysfunctions for mortality prediction.DesignWe have carried out a nonprespecified, secondary analysis of a prospective dataset collected from September 2011 to December 2015.SettingEmergency departments, wards, and PICUs in 10 tertiary children's hospitals in Switzerland.PatientsChildren younger than 17 years old with blood culture-proven sepsis. We excluded preterm infants and term infants younger than 7 days old.InterventionsNone.Measurements And Main ResultsWe compared the 2005 International Pediatric Sepsis Consensus Conference (IPSCC), Pediatric Logistic Organ Dysfunction-2 (PELOD-2), pediatric Sequential Organ Failure Assessment (pSOFA), and Pediatric Organ Dysfunction Information Update Mandate (PODIUM) scores, measured at blood culture sampling, to predict 30-day mortality. We analyzed 877 sepsis episodes in 807 children, with a 30-day mortality of 4.3%. Percentage with organ dysfunction ranged from 32.7% (IPSCC) to 55.3% (pSOFA). In adjusted analyses, the accuracy for identification of 30-day mortality was area under the curve (AUC) 0.87 (95% CI, 0.82-0.92) for IPSCC, 0.83 (0.76-0.89) for PELOD-2, 0.85 (0.78-0.92) for pSOFA, and 0.85 (0.78-0.91) for PODIUM. When restricting scores to neurologic, respiratory, and cardiovascular dysfunction, the adjusted AUC was 0.89 (0.84-0.94) for IPSCC, 0.85 (0.79-0.91) for PELOD-2, 0.87 (0.81-0.93) for pSOFA, and 0.88 (0.83-0.93) for PODIUM.ConclusionsIPSCC, PELOD-2, pSOFA, and PODIUM performed similarly to predict 30-day mortality. Simplified scores restricted to neurologic, respiratory, and cardiovascular dysfunction yielded comparable performance.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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