Novel Criteria Validated for Pediatric Sepsis, Septic Shock
29 Jan 2024
Clinical Result
MONDAY, Jan. 29, 2024 -- The Phoenix Criteria are valid for identifying sepsis and septic shock in children, according to two studies published online Jan. 21 in the Journal of the American Medical Association to coincide with the Society of Critical Care Medicine annual Critical Care Congress, held from Jan. 21 to 23 in Phoenix.
Luregn J. Schlapbach, M.D., Ph.D., from the University Children's Hospital Zurich, and colleagues evaluated and updated criteria for sepsis and septic shock in children. The researchers developed new criteria for sepsis and septic shock based on data from an international survey, systematic review, an analysis of more than 3 million pediatric health care encounters, and a consensus process. The authors found that sepsis can be identified by a Phoenix Sepsis Score of ≥2 points in children with suspected infection, indicating life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. In-hospital mortality was 7.1 and 28.5 percent higher in higher- and lower-resource settings, respectively, for children with versus without a Phoenix Sepsis Score of at least 2 points. Children with sepsis who had cardiovascular dysfunction, indicated by at least one cardiovascular point in the Phoenix Sepsis Score, were defined as having septic shock.
L. Nelson Sanchez-Pinto, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues derived and validated novel criteria for pediatric sepsis and septic shock in a multicenter, international, retrospective cohort study. The researchers found that a four-organ system model performed best among the 172,984 children with suspected infection in the first 24 hours (development set, 1.2 percent mortality). For predicting mortality in the validation sets, the integer version of that model, the Phoenix Sepsis Score, had areas under the precision recall curve of 0.23 to 0.38 and areas under the receiver operating characteristic curve of 0.71 to 0.92.
"These criteria are better than the old ones at identifying children with infections at higher risk of poor outcomes and are globally applicable, including in low-resource settings," Sanchez-Pinto said in a statement.
Several authors from both studies disclosed ties to industry.
Abstract/Full Text - Schlapbach
Abstract/Full Text - Sanchez-Pinto
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Posted January 2024
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