Application of a modified sequential organ failure assessment score to critically ill patients

Abstract

The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.

The prognostic value of a trend in modified SOFA score for patients with hematological malignancies in the intensive care unit

“…The conclusions of other studies that the neurological component can also be omitted were confirmed in this patient group …”

“…First, as platelets are an important part of the SOFA score, it can be envisaged that the thrombocytopenia in patients with a hematological malignancy admitted to the ICU is an expression of the underlying hematological disease rather than a reflection of the current problem. Second, recent studies evaluated a modified SOFA score in medical and surgical patients, omitting the neurological score and showed this score was significantly associated with mortality . The neurological score was excluded as the results of the neurological evaluation are most commonly influenced by the use of sedatives.…”

Perbandingan Validitas Sistem Skoring Apache II, SOFA, Dan Customized Sequential Organ Failure Assessment (Csofa) Untuk Memperkirakan Mortalitas Pasien Non-Bedah Yang Dirawat Di Ruang Perawatan Intensif

“…Sub variabel ginjal dengan penelitian kreatinin serum didapatkan berhubungan bermakna dengan mortalitas pada penelitian sebelumnya. 5,7,8,11 Namun penelitian tersebut menggunakan populasi nonbedah dan bedah dengan dominan populasi bedah, sebaliknya pada penelitian ini menggunakan populasi non-bedah saja. Pada populasi nonbedah didapatkan pasien dengan CKD yang telah terkompensasi dengan keadaan tersebut sehingga tidak memberi pengaruh yang signifikan.…”

Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan

“…Ada beberapa sistem penilaian alternatif yang telah diteliti untuk menentukan tingkat mortalitas pasien, seperti MEXSOFA, SOFA, MSOFA, dan CSOFA. 8,10,11 Sistem penilaian APACHE II dan SOFA saat ini digunakan pada berbagai IRI di benua Eropa dan Amerika. Namun, kedua sistem penilaian ini memiliki kelemahan yang sejalan dengan peningkatan kualitas manajemen kesehatan, dengan demikian kedua sistem penilaian di atas menjadi overestimate dan kurang efisien serta tidak cost effective dalam memprediksi mortalitas.…”

“…Namun, SOFA juga masih kurang praktis karena di sebagian rumah sakit beberapa parameter masih sulit didapatkan (PaO 2 , bilirubin, dan GCS) sehingga dikembangkan modifikasi skor SOFA, yaitu customized sequential organ failure assessment (CSOFA) dan mexican sequential organ failure assessment (MEXSOFA). 10,11 Berdasar atas hasil penelitian tersebut di atas, nilai validitas tiap-tiap sistem penilaian didapatkan dengan melihat AuROC, yaitu APACHE II 0,892, SOFA 0,919, dan CSOFA 0,9172, 1…”