pSOFA

Quantify organ dysfunction in pediatric sepsis. Age-adjusted version of adult SOFA. Used for the Sepsis-3 definition in children.

Indication

Quantify organ dysfunction in pediatric sepsis. Age-adjusted version of adult SOFA. Used for the Sepsis-3 definition in children.

Criteria

id: resp; label: Respiratory (PaO2/FiO2 or SpO2/FiO2); type: options; options: value: 0; label: P/F ≥400 or S/F ≥292; value: 1; label: P/F 300–399 or S/F 264–291; value: 2; label: P/F 200–299 or S/F 221–263; value: 3; label: P/F 100–199 or S/F 148–220 (support); value: 4; label: P/F <100 or S/F <148 (support)
id: coag; label: Coagulation (platelets ×10³/µL); type: options; options: value: 0; label: ≥150; value: 1; label: 100–149; value: 2; label: 50–99; value: 3; label: 20–49; value: 4; label: <20
id: liver; label: Liver (bilirubin mg/dL); type: options; options: value: 0; label: <1.2; value: 1; label: 1.2–1.9; value: 2; label: 2.0–5.9; value: 3; label: 6.0–11.9; value: 4; label: ≥12
id: cardio; label: Cardiovascular (age-adjusted MAP / vasoactives); type: options; options: value: 0; label: Age-appropriate MAP; value: 1; label: MAP below age-appropriate; value: 2; label: Dopamine ≤5 or dobutamine (any); value: 3; label: Dopamine >5 or epi ≤0.1 or norepi ≤0.1; value: 4; label: Dopamine >15 or epi >0.1 or norepi >0.1
id: neuro; label: Neurological (GCS — Pediatric GCS for <2 years); type: options; options: value: 0; label: 15; value: 1; label: 13–14; value: 2; label: 10–12; value: 3; label: 6–9; value: 4; label: <6
id: renal; label: Renal (creatinine — age-adjusted, see reference); type: options; options: value: 0; label: Normal for age; value: 1; label: Mildly elevated; value: 2; label: Moderately elevated; value: 3; label: Severely elevated; value: 4; label: Markedly elevated / failure

Interpretation

function(score) { if (score <= 6) return { risk: score + '/24', tier: 'Low mortality', action: 'Limited organ dysfunction. Source control + supportive care. pSOFA \u22652 from baseline + suspected infection = sepsis.', color: 'green' }; if (score <= 9) return { risk: score + '/24', tier: 'Moderate mortality', action: 'Significant organ dysfunction. Escalate resuscitation; PICU-level care.', color: 'yellow' }; if (score <= 12) return { risk: score + '/24', tier: 'High mortality (~40\u201350%)', action: 'Multi-organ dysfunction. Aggressive PICU management.', color: 'red' }; return { risk: score + '/24', tier: 'Very high mortality (>50%)', action: 'Severe multi-organ failure. Maximal support; discuss goals of care.', color: 'red' }; }

Clinical pearls

pSOFA ≥2 from baseline in a child with suspected infection meets Sepsis-3 pediatric criteria
Cardiovascular component uses age-adjusted MAP — a MAP of 55 is acceptable in a neonate but alarming in a teenager
The Phoenix Sepsis Score (2024) is now recommended but pSOFA remains in widespread use

Source and review

Matics TJ and Sanchez-Pinto LN. JAMA Pediatr 2017. Last reviewed: 2025-01-01