{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:55:02Z","timestamp":1790834102437,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006379","name":"Fund \u201cScience\u201d of the Medical University of Varna","doi-asserted-by":"publisher","award":["21022\/2021"],"award-info":[{"award-number":["21022\/2021"]}],"id":[{"id":"10.13039\/501100006379","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical University of Varna","award":["21022\/2021"],"award-info":[{"award-number":["21022\/2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Early identification of pediatric sepsis complications in intensive care is challenging and requires improved diagnostic tools. This study aimed to compare the Phoenix Sepsis Score (PSS), pSOFA, PELOD-2, and PRISM III in assessing clinical complexity in children with septic and critical conditions in the PICU and to identify the most suitable scale for this patient cohort. Methods: Data were collected prospectively from 53 children between June 2022 and January 2024. Patients were categorized into septic (n = 42) and non-infectious SIRS (n = 11) and further classified by outcome\u2014with\/without complications (n = 23\/30). The predictive accuracy of the scoring systems was evaluated by discrimination and calibration and by recalibration for the PSS for improved performance. Results: Respiratory (18.8%) and neurological complications (9.4%) were the most common adverse events. Clinical deterioration was observed in 43.4% of cases, including one fatality. Patients with complications stayed longer in the PICU (14 \u00b1 10 days). In the patients with complications, all scoring systems had higher median values. Only PSS showed a significant difference (p = 0.0023). PSS demonstrated the highest overall predictive accuracy (76.2%) outperforming PRISM III (62.3%) and PELOD-2 (58.5%). The pSOFA scale showed high accuracy (88.0%) in identifying patients without complications. The strongest association was between chronic disease (hazard ratio Exp(B) = 1.718) and deteriorations, while mechanical ventilation suggested a reduced risk of complications (Exp(B) = 0.509). Conclusions: PSS showed superior predictive accuracy (76.2%) for deteriorations in pediatric patients with suspected infection and proved adaptable for further validation in larger populations.<\/jats:p>","DOI":"10.3390\/children12030262","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:47:46Z","timestamp":1740109666000},"page":"262","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Assessment of Phoenix Sepsis Score, pSOFA, PELOD-2, and PRISM III in Pediatric Intensive Care"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3036-1918","authenticated-orcid":false,"given":"Adriana","family":"Hadzhieva-Hristova","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"First Clinic and PICU, St. Marina University Hospital, 9010 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darina","family":"Krumova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"First Clinic and PICU, St. Marina University Hospital, 9010 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temenuga","family":"Stoeva","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Virology, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"Microbiology Laboratory, St. Marina University Hospital, 9010 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralitza","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Medical University of Sofia, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta","family":"Iotova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria"},{"name":"First Clinic and PICU, St. Marina University Hospital, 9010 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3233\/PIC-13068","article-title":"History of pediatric critical care medicine","volume":"2","author":"Levin","year":"2015","journal-title":"J. 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