pSOFA (Pediatric SOFA)

pSOFA total = respiratory + coagulation + hepatic + cardiovascular + neurologic + renal: six organ subscores, each 0–4, summed to 0–24 (Matics & Sanchez-Pinto 2017). Respiratory uses P/F when a PaO₂ exists (≥400 → 0; 300–399 → 1; 200–299 → 2; 100–199 → 3; <100 → 4), otherwise S/F, only at SpO₂ ≤ 97% (≥292 → 0; 264–291 → 1; 221–264 → 2; 148–220 → 3; <148 → 4); an exact 264 resolves to the worse subscore (2), per the worst-value rule. Subscores 3–4 require respiratory support, so a 3/4-band ratio without support is capped at 2; that cap is entailed by the published table, not added here. Coagulation from platelets (×10³/µL): ≥150 → 0; 100–149 → 1; 50–99 → 2; 20–49 → 3; <20 → 4. Hepatic from total bilirubin (mg/dL): <1.2 → 0; 1.2–1.9 → 1; 2.0–5.9 → 2; 6.0–11.9 → 3; ≥12 → 4. Cardiovascular is the worse of the age-banded MAP subscore (0 or 1) and the vasoactive tier: dobutamine any dose or dopamine ≤5 → 2; dopamine >5 or epinephrine ≤0.1 or norepinephrine ≤0.1 → 3; dopamine >15 or epinephrine >0.1 or norepinephrine >0.1 → 4 (µg/kg/min). Neurologic from total GCS: 15 → 0; 13–14 → 1; 10–12 → 2; 6–9 → 3; <6 → 4. Renal from serum creatinine against age-banded cut points. Seven age bands (<1, 1–11, 12–23, 24–59, 60–143, 144–216, >216 months); above 216 months the MAP and creatinine cut points are adult SOFA’s. Missing data scores that organ 0, which is the paper’s own rule that a variable unmeasured in the 24 h window is taken as normal, so a partial entry reads lower than a complete one.

Missing data scores that organ 0. That is the paper’s own rule, a variable unmeasured in the 24 h window taken as normal, so a partial entry reads lower than a complete one. An SpO₂ above 97% with no PaO₂ falls into that trap WITHOUT the field being blank: the ratio is unusable above 97%, so the respiratory subscore is taken as 0 and the total reads lower than the child is. The published S/F table prints 264 in two rows at once, as the lower bound of the subscore-1 row and the upper bound of the subscore-2 row, so the source assigns an exact 264 to both; this calculator resolves it to the worse subscore (2), per the worst-value rule. Subscores 3–4 require respiratory support, and a 3/4-band ratio without support is capped at 2; that cap is entailed by the published table, not added here. What counts as support is undefined in the paper, and this calculator’s reading is that invasive or non-invasive support both qualify, high-flow included. Phoenix contrast, worth stating once: pSOFA attaches its support requirement to the top two respiratory bands, capping an unsupported child at 2, while Phoenix multiplies every tier by a support flag, flooring an unsupported child at 0. The same child at the same ratio can be pSOFA respiratory 2 and Phoenix respiratory 0 simultaneously. Both implement their own instrument correctly; neither should be harmonised to the other. A total above 8 sits above the maximum-pSOFA cut point that best separated survivors from non-survivors in the single-center derivation cohort (AUROC 0.94). That is a statistical association on the encounter maximum, not a treatment threshold. Scope: pSOFA was derived in children 21 years and younger. The <1-month band exists, but neonates were not the derivation population; nSOFA is the score derived for preterm very-low-birth-weight infants. Age input runs to 250 months deliberately, since the cohort ran to 252.