ArticleScientific reports2026
External validation of the Phoenix Sepsis Score in a paediatric intensive care unit in Saudi Arabia.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We externally validated the Phoenix Sepsis Score (PSS) for predicting n-hospital mortality in a Paediatric Intensive Care Unit (PICU) setting in Saudi Arabia and compared its performance with those of the International Paediatric Sepsis Consensus Conference (IPSCC) criteria and Paediatric Logistic Organ Dysfunction-2 (PELOD-2) score. This retrospective cohort study of a prospectively maintained paediatric sepsis registry included 0–14-year-old PICU-admitted children with suspected sepsis between 2015 and 2023. Of 431 admissions, 281 (65.2%) met the PSS criteria (PSS ≥ 2), of whom 197/281 patients (70.1%) met the septic shock criteria. The in-hospital mortality rates were 21.8% for the entire cohort, 12% for infection, and 27% for sepsis. A PSS ≥ 2 yielded a sensitivity of 80.9% (95% confidence interval [CI]: 71.7–87.5) and positive predictive value of 27.0% (95%CI: 22.2–32.5). The area under the precision-recall curve for the PSS was 0.45 (95% CI: 0.35–0.56), which was higher than that for the IPSCC criteria (0.38, 95%CI: 0.29–0.48) and comparable to that for the PELOD-2 score (0.48, 95%CI: 0.37–0.58). PSS discriminative performance, assessed by the area under the receiver-operating characteristic curve, was 0.67 (95% CI: 0.61–0.74), similar to that of the IPSCC criteria (0.67, 95%CI: 0.60–0.73) and PELOD-2 score (0.72, 95%CI: 0.65–0.77). The PSS demonstrated favourable precision-recall performance and fair discrimination for in-hospital mortality in this critical care cohort. Its precision-recall performance was superior to that of the IPSCC criteria and comparable to that of the PELOD-2 score. Notably, the PSS relies on fewer variables across four organ systems, which may enhance its practicality for risk stratification in comparable high-acuity critically ill children.
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