Development and Validation of Pediatric Sepsis Score in the Prediction of Pediatric Septic Shock
Onsuthi Pharadornuwat, MD¹, Chanapai Chaiyakulsil, MD¹, Duangtip Tiacharoen, MD¹
Affiliation : ¹ Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand
Background: Early recognition and identification of sepsis with appropriate resuscitation and prompt monitoring would improve the outcome of children with sepsis.
Objective: To develop and validate the new pediatric sepsis screening tool for predicting septic shock in children in all settings, including emergency departments, outpatient clinics, and inpatient settings.
Materials and Methods: This study was a retrospective, cross-sectional study. This study was divided into two phases: score development and validation. All eligible children aged one month to 15 years old who visited outpatient clinics, the emergency department, or were admitted to the hospital and who were at risk for sepsis were included. The new screening tool scoring system was derived from the abnormal physiological parameters according to age, from the consensus of the experts, with a decent content validity index. The final score for each participant was used to validate the prediction of septic shock using the area under the receiver operating curve (AUROC), sensitivity, and specificity.
Results: Seven hundred ninety-four screenings were done in this study. Of these, 15 episodes (1.89%) were diagnosed with septic shock. Abnormal parameters (including hypotension, abnormal pulse pressure, desaturation, abnormal capillary refill time, and decreased sensorium) were significantly associated with septic shock. The overall performance of the Thammasat University Hospital (TUH) pediatric sepsis screening tool in all settings to predict septic shock, as measured by the AUROC, was 0.990 (95% CI 0.981 to 0.998). With a sepsis score of at least 3, the sensitivity and specificity were 100% and 95.4%, respectively. The AUROC, sensitivity, and specificity were still excellent in the subgroup of inpatient and outpatient/emergency department settings.
Conclusion: This study showed that the TUH pediatric sepsis screening tool provided high sensitivity and specificity for the diagnosis of septic shock in inpatient and outpatient/emergency department settings.
Received 20 November 2025 | Revised 26 January 2026 | Accepted 30 January 2026
DOI: 10.35755/jmedassocthai.2026.5.03903
Keywords : Pediatric sepsis screening tool; Sepsis score; Septic shock
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