Nghia Quang BUI, Nguyen Phat NGUYEN, Thanh Huy ONG, Phuong Minh NGUYEN, Thi Van VO, Mai Anh Minh TRUONG, Duc Minh Hoang TRAN, Dien Minh THAI
Trends in Pediatrics - 2026;7(3):159-166
Background: Pediatric sepsis remains a critical global health concern due to its high morbidity and mortality. Several clinical scoring systems have been employed to assess disease severity and predict outcomes in patients with sepsis. The Phoenix Sepsis Score is a recently proposed pediatric-specific tool for risk stratification, but evidence on its performance in Southeast Asia remains limited. Objective: To evaluate clinical outcomes and assess the prognostic performance of the Phoenix Sepsis Score in predicting mortality among pediatric patients with sepsis. Materials and Methods: A cross-sectional analytical study was conducted on 94 pediatric patients (aged 2 months to 16 years) with sepsis admitted to a tertiary referral hospital in the Mekong Delta, Vietnam. Clinical, laboratory, and scoring variables were recorded within the first 6 hours after the diagnosis of sepsis. Prognostic performance was assessed using receiver operating characteristic curve analysis. Results: Among 94 patients, 67% were under 5 years of age. Lower Glasgow Coma Scale scores (10.96 +/- 3.61 vs. 14.19 +/- 3.41; p<0.001) and higher rates of septic shock (61.5% vs. 20.6%; p<0.001) were observed among non-survivors compared with survivors. The use of vasoactive agents (96.2% vs. 26.5%; p<0.001), mechanical ventilation (92.3% vs. 38.2%; p<0.001), and >=2 antibiotic modifications (80.8% vs. 55.9%; p=0.026) were also associated with mortality. The Phoenix Sepsis Score demonstrated high discriminative ability (area under the curve [AUC], 0.947; 95% confidence interval [CI], 0.90-0.99), similar to that of the pediatric Sequential Organ Failure Assessment (pSOFA) score (AUC, 0.943; 95% CI, 0.898-0.988). At optimal cutoffs of 3.5 and 8.5 points, respectively, the Phoenix Sepsis Score showed higher sensitivity (92.3% vs. 76.9%), whereas pSOFA showed higher specificity (91.2% vs. 83.8%). Conclusion: The Phoenix Sepsis Score demonstrated prognostic performance similar to that of pSOFA in this cohort, with higher sensitivity but lower specificity. These findings suggest that the Phoenix Sepsis Score may be useful as a supportive tool for early risk stratification in pediatric sepsis, particularly in resource-limited settings. Further multicenter studies are required to validate these findings.
