External Validation of the Phoenix Sepsis Score in Children With Suspected Community-Acquired Sepsis
Authors' conclusion
In this multicenter diagnostic study of children hospitalized with suspected sepsis, the Phoenix Sepsis Score and sepsis criteria had similar performance to the original derivation and validation cohorts.
Study context
- Population
- Children admitted through 11 EDs in Australia and New Zealand, treated with parenteral antibiotics for suspected community-acquired sepsis (SENTINEL study, 2021–2023)included in the analysis
- Participants
- 6,232 children
- Comparison
- Phoenix Sepsis Score and sepsis criteria for predicting mortality
- Phoenix sepsis criterian = 306
- Outcome
- (1) In-hospital mortality and (2) death or requirement for ECLS within 72 hours of hospitalization
Methodological detailsexternal validation, multicentre, multicountry, Coagulation data for the Phoenix Sepsis Score missing in more than 85% of children
- External validation
- Multicentre
- Multicountry
- Coagulation data for the Phoenix Sepsis Score missing in more than 85% of children
Performance
As reported in the abstract
In-hospital mortality; death or ECLS within 72 hours
| Test or model | Sensitivity, in-hospital mortality | PPV, in-hospital mortality | Sensitivity, death or extracorporeal life support (ECLS) within 72 hours | PPV, death or ECLS within 72 hours | Died in hospital among those meeting criteria | Died or ECLS within 72 hours among those meeting criteria |
|---|---|---|---|---|---|---|
| Phoenix sepsis criteria | 55.0% (95% CI, 41.6%-67.9%) | 10.8% (95% CI, 7.6%-14.9%) | 77.8% (95% CI, 60.8%-89.9%) | 9.2% (95% CI, 6.2%-13.0%) | 33 (10.8%) | 28 (9.2%) |
Phoenix sepsis criteria
Sensitivity, in-hospital mortality55.0% (95% CI, 41.6%-67.9%)
PPV, in-hospital mortality10.8% (95% CI, 7.6%-14.9%)
Sensitivity, death or extracorporeal life support (ECLS) within 72 hours77.8% (95% CI, 60.8%-89.9%)
PPV, death or ECLS within 72 hours9.2% (95% CI, 6.2%-13.0%)
Died in hospital among those meeting criteria33 (10.8%)
Died or ECLS within 72 hours among those meeting criteria28 (9.2%)
- Worst Phoenix Sepsis Score over first 24 hours, area under precision recall curve, in-hospital mortality
- 0.17 (95% CI, 0.07-0.28)
- Worst Phoenix Sepsis Score over first 24 hours, area under precision recall curve, death or ECLS within 72 hours
- 0.23 (95% CI, 0.11-0.36)
- Overall in-hospital mortality
- 60 (1.0%)
- Overall death or ECLS within 72 hours
- 36 (0.6%)
- Children meeting Phoenix sepsis criteria
- 306 (4.9%)
Original publication
External Validation of the Phoenix Sepsis Score in Children With Suspected Community-Acquired Sepsis. JAMA Netw Open. Published 3 March 2025. doi:10.
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