X Peng, X Sun, X Chen, L Liu, J Lu, L Dong

Abstract

Introduction: Sepsis is the most common critical illness in clinical settings, and septic acute kidney injury (AKI) is a major cause of mortality in paediatric patient. Methods: We aimed to investigate scoring systems for determining the severity of septic AKI through mortality prediction using Pediatric Risk of Mortality III (PRISM III), Pediatric Multiple Organ Dysfunction Score (P-MODS), and Pediatric Critical Illness Score (PCIS). The clinical data of 102 paediatric patients with septic AKI admitted to the paediatric intensive care unit from January 2014 to December 2018 were collected. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cutoff values of the scoring systems for assessing mortality. Results: There were 25.64% death rates among patients with stage 1 disease, 45% with stage 2 disease, and 58.14% with stage 3 disease, with a significant difference (x²=8.8409, p=0.012). The cutoff values of the ROC curves of PRISM III, P-MODS, and PCIS were 12, 6, and 82, respectively, in patients with not staged septic AKI; 12, 5, and 84, respectively, in patients with stage 1 septic AKI; 17, 9, and 72, respectively, in patients with stage 2 septic AKI; and 12, 7, and 74, respectively, in patients with stage 3 septic AKI. Conclusions: PRISM III was the best mortality risk assessment system for paediatric patients with not staged septic AKI. PCIS was better in predicting the mortality risk of paediatric patients with stage 1 AKI, whereas PRISM III was better for paediatric patients with stage 2 and 3 AKI.