ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2025
The Phoenix Sepsis Score in Pediatric Oncology Patients With Sepsis at PICU Admission: Test of Performance in a European Multicenter Cohort, 2018-2020.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- The phoenix sepsis score for high mortality risk identification and prognostic predict in pediatric liver transplant recipients.European journal of pediatrics · 2026Article
- A comparison of pediatric sepsis definitions based on systemic inflammatory response syndrome and Phoenix criteria: a single-center PICU retrospective study.Italian journal of pediatrics · 2026Article
- The Phoenix Criteria and Other Severity Scores in Identifying Pediatric Sepsis.JAMA network open · 2026Article
- Clinical Scores for Predicting Outcomes in Pediatric Oncology Sepsis: A Systematic Review and Meta-Analysis.Critical care research and practice · 2026Review
- Utility of the Phoenix-8 and PELOD-2 scales in pediatric patients with sepsis and acute lymphoblastic leukemia admitted to a pediatric intensive care unit at a quaternary-level hospital in Bogotá, Colombia, 2022-2024.Frontiers in pediatrics · 2026Article
- We Have New Sepsis Criteria for Children…Now What?Hospital pediatrics · 2025Article
- Risk factors for mortality and development of a predictive model in pediatric sepsis.Frontiers in pediatrics · 2025Article
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15 authors.
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Abstract
objectivesThe Pediatric Sepsis Definition Task Force developed and validated a new organ dysfunction score, the Phoenix Sepsis Score (PSS), as a predictor of mortality in children with suspected or confirmed infection. The PSS showed improved performance compared with prior scores. However, the criteria were derived in a general pediatric population, in which only 10% had cancer. Given that pediatric cancer patients with sepsis have higher mortality compared with noncancer patients with sepsis, we aimed to assess the PSS in PICU patients with cancer and sepsis.
designRetrospective multicenter cohort study.
settingTwelve PICUs across Europe. PATIENTS: Each PICU identified patients 18 years young or younger, with underlying malignancy and suspected or proven sepsis, and admission between January 1, 2018, and January 1, 2020.
interventionsNone. MEASUREMENTS AND MAIN
resultsThe PSS and three other scores, including Phoenix-8, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, and pediatric Sequential Organ Failure Assessment (pSOFA) score, were calculated for comparison. The primary outcome was 90-day all-cause mortality. We compared score performance using area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) analyses. Among 383 patients with proven or suspected sepsis, 90-day mortality was 19.3% (74/383). We failed to identify an association between a particular score and performance for 90-day mortality. The mean (95% CI) values for the AUROC of each score was: PSS 0.66 (0.59-0.72), Phoenix-8 0.65 (0.58-0.72), PELOD-2 0.64 (0.57-0.71), and pSOFA 0.67 (0.60-0.74) and for the AUPRC of each score: PSS 0.32 (0.23-0.42), Phoenix-8 0.32 (0.23-0.42), PELOD-2 0.32 (0.22-0.43), and pSOFA 0.36 (0.26-0.46). Similar results were obtained for PICU mortality or sepsis-related PICU mortality.
conclusionsContrary to the general PICU population, our retrospective test of the PSS in a PICU oncology dataset with suspected or proved sepsis from European PICUs, 2018-2020, failed to identify improved performance in association with mortality. This unique patient population deserves development of organ dysfunction scores that reflect organ dysfunction and mortality data specifically from these patients and will require prospective validation in future studies.
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