A SOFA for PICU?

It is important to have consistent and reproducible measures of just how ill children on paediatric intensive care units (PICUs) are. Without this it is impossible to compare outcomes meaningfully. This has proved difficult, with different systems currently in use. In adults, the Sequential Organ Failure Assessment (SOFA) score has proved very useful, particularly in sepsis. However it was never intended for children. The PICU team from Chicago Children’s Hospital have published their assessment of the performance of their paediatric adaptation of SOFA, dubbed pSOFA (Matics T et al. JAMA Peds 2017. doi:10.1001/jamapediatrics.2017.2352). It resembles the adult system in that scores are awarded for degree of organ dysfunction in each system (cardiovascular, renal, neurological, hepatic etc), but they adjusted cut-off physiological values according to age, and also used the less invasive SaO₂ rather than PaO₂ for the respiratory domain.

They gathered data retrospectively from over 8700 admissions, aged …