Prognostic of Sepsis in a Congolese Pediatric Emergency Service Using PSOFA Score: A Prospective Study

Author(s): Jacques Balekelayi wa Balekelayi*, Valérie Bolingo Bola, Stéphanie Mikalo Mbambi, Joseph Mabiala Bodi, Victoire Audray Bikoumou, Ariane Mankiele Keto, Mamy-gloire Manzi Monkoti, Thideline Mankanga Mabela, Agathe Maku Fwani, Karem Efombola Itokua, Jennifer Misengabu Lembalemba, Célestin Ndosimao Nsibu

Background: The pediatric emergency service represents a very important link in the care of sick children and children with serious medical conditions, such as sepsis. In the Democratic Republic of Congo (DRC), mortality from sepsis in children is still very high and no study has analyzed the influence of the pSOFA score on vital prognosis in the emergency service.

Methodology: Prospective observational cross-sectional study from April 1 to September 30, 2022. We included all children aged 1 to 15 suspected of sepsis according to SIRS criteria in the Emergency Room of Pediatrics at Saint-Joseph Hospital in Kinshasa, Democratic Republic of Congo. The pSOFA score was calculated for all patients within 24 hours after infection was first suspected in the emergency department and was correlated with their evolution within 7 days. The usual statistics were used.

Results: Of 92 patients collected in the study, 10 patients had died within 7 days of suspicion of sepsis, including 9 with a pSOFA score ≥ 2 and 1 with a pSOFA score < 2. Respiratory distress, coma, convulsions, oliguria, shock and hypothermia were significantly found in patients with a pSOFA score ≥ 2. In univariate analysis, we noted that the pSOFA score ≥2 and the admission time ≥ 6 days were significantly associated with mortality within 7 days with a risk multiplied by 18 and 9 respectively.

Conclusion: Beyond diagnosing sepsis, the pSOFA score may be a good predictor of its mortality.