Pediatric Sequential Organ Failure Assessment (pSOFA) Score

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The SOFA score at admission is useful for predicting outcomes in the Paediatric Intensive Care Units (PICUs) and is more accurate than SIRS for definition of paediatric sepsis.

Pediatric Sequential Organ Failure Assessment (pSOFA) Score

Variables Scorea
0 1 2 3 4
Respiratory
PaO2:FiO2 b
or
≥400 300-399 200-299 100-199 With respiratory support <100 With respiratory support
SpO2:FiO2 c ≥292 264-291 221-264 148-220 With respiratory support <148 With respiratory support
Coagulation
Platelet count, ×103 /μL ≥150 100-149 50-99 20-49 <20
Hepatic
Bilirubin, mg/dL <1.2 1.2-1.9 2.0-5.9 6.0-11.9 >12.0
Cardiovascular
MAP by age group or vasoactive infusion, mm Hg or μg/kg/mind
<1 mo ≥46 <46 Dopamine hydrochloride ≤5 or dobutamine hydrochloride (any) Dopamine hydrochloride >5 or epinephrine ≤0.1 or norepinephrine bitartrate ≤0.1 Dopamine hydrochloride >15 or epinephrine >0.1 or norepinephrine bitartrate >0.1
1-11 mo ≥55 <55
12-23 mo ≥60 <60
24-59 mo ≥62 <62
60-143 mo ≥65 <65
144-216 mo ≥67 <67
>216 moe ≥70 <70
Neurologic
Glasgow Coma Scoref 15 13-14 10-12 6-9 <6
Renal
Creatinine by age group, mg/dL
<1 mo <0.8 0.8-0.9 1.0-1.1 1.2-1.5 ≥1.6
1-11 mo <0.3 0.3-0.4 0.5-0.7 0.8-1.1 ≥1.2
12-23 mo <0.4 0.4-0.5 0.6-1.0 1.1-1.4 ≥1.5
24-59 mo <0.6 0.6-0.8 0.9-1.5 1.6-2.2 ≥2.3
60-143 mo <0.7 0.7-1.0 1.1-1.7 1.8-2.5 ≥2.6
144-216 mo <1.0 1.0-1.6 1.7-2.8 2.9-4.1 ≥4.2
>216 moe <1.2 1.2-1.9 2.0-3.4 3.5-4.9 ≥5

Abbreviations: FiO2, fraction of inspired oxygen; MAP, mean arterial pressure; pSOFA, pediatric Sequential Organ Failure Assessment; SpO2, peripheral oxygen saturation. SI conversion factors: To convert bilirubin to micromoles per liter, multiply by 17.104; creatinine to micromoles per liter, multiply by 88.4; and platelet count to ×109/L, multiply by 1.
a The pSOFA score was calculated for every 24-hour period. The worst value for every variable in each 24-hour period was used to calculate the subscore for each of the 6 organ systems. If a variable was not recorded in a given 24-hour period, it was assumed to be normal and a score of 0 was used. Daily pSOFA score was the sum of the 6 subscores (range, 0-24 points; higher scores indicate a worse outcome).
b PaO2 was measured in millimeters of mercury.
c Only SpO2 measurements of 97% or lower were used in the calculation.
d MAP (measured in millimeters of mercury) was used for scores 0 and 1; vasoactive infusion (measured in micrograms per kiligram per minute), for scores 2 to 4. Maximum continuous vasoactive infusion was administered for at least 1 hour.
e Cutoffs for patients older than 18 years (216 months) were identical to the original SOFA score.
f Glasgow Coma Scale was calculated using the pediatric scale.

 

References:

  1. Matics TJ, Sanchez-Pinto LN. Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children. JAMA Pediatr. 2017;171(10):e172352. [Medline]
  2. Mohamed El-Mashad G, Said El-Mekkawy M, Helmy Zayan M. La escala pediátrica de evaluación del fallo multiorgánico secuencial (pSOFA): una nueva escala de predicción de la mortalidad en la unidad de cuidados intensivos pediátricos [Paediatric sequential organ failure assessment (pSOFA) score: A new mortality prediction score in the paediatric intensive care unit]. An Pediatr (Barc). 2020;92(5):277-285. [Medline]

 

Created Jul 28, 2020.