A new SOFA score calculation to improve the predictive performance for mortality in sepsis-associated disseminated intravascular coagulopathy patients

Arakawa, Makoto; Levy, Jerrold H.; Fujimori, Kenji; Kondo, Kenta; Iba, Toshiaki

doi:10.1016/j.jcrc.2021.03.008

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Another study contradicted our results where the SOFAComb showed better accuracies than SOFAΔ on days 2, 4, and 7 (11) . This would be explained by their recruitment of patients with sepsis-associated DIC and introduction of antithrombin supplementation as a treatment.…”

Section: Discussioncontrasting

confidence: 99%

“…Additionally, there were missing data in their analysis impairing data validation due to selection bias. Also, this study was a retrospective study (11) .…”

Section: Discussionmentioning

confidence: 99%

“…However, SOFAΔ can't reflect the effect of treatment as a prolonged time would be needed. This drawback would be solved with the use of the absolute SOFA score giving priority to SOFAComb in patient's prognostication (11) .…”

Section: Discussionmentioning

confidence: 99%

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Predictive Value of New Sequential Organ Failure Assessment (SOFA) Score of Mortality in Critically Ill Patients in Emergency Department in Suez Canal University Hospital

Moussa

Beltagy²,

Taha³

2023

The Egyptian Journal of Hospital Medicine

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Section: Discussioncontrasting

confidence: 99%

“…Additionally, there were missing data in their analysis impairing data validation due to selection bias. Also, this study was a retrospective study (11) .…”

Section: Discussionmentioning

confidence: 99%

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Predictive Value of New Sequential Organ Failure Assessment (SOFA) Score of Mortality in Critically Ill Patients in Emergency Department in Suez Canal University Hospital

Moussa

Beltagy²,

Taha³

2023

The Egyptian Journal of Hospital Medicine

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“…Past efforts to improve on the SOFA score have produced mixed results [16-18]. However, our research supports these endeavors, suggesting that an enhanced SOFA score incorporating social determinants of health could sharpen the predictive accuracy for mortality in sepsis patients.…”

Section: Discussionsupporting

confidence: 51%

Integrating Social Determinants of Health with SOFA Scoring to Enhance Mortality Prediction in Septic Patients: A Multidimensional Prognostic Model

Sarraf,

Sadr,

Abedi

et al. 2024

Preprint

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BackgroundThe Sequential Organ Failure Assessment (SOFA) score is an established tool for monitoring organ failure and defining sepsis. However, its predictive power for sepsis mortality may not account for the full spectrum of influential factors. Recent literature highlights the potential impact of socioeconomic and demographic factors on sepsis outcomes.ObjectiveThis study assessed the prognostic value of SOFA scores relative to demographic and social health determinants in predicting sepsis mortality, and evaluated whether a combined model enhances predictive accuracy.MethodsWe utilized the Medical Information Mart for Intensive Care (MIMIC)-IV database for retrospective data and the Penn State Health (PSH) cohort for prospective external validation. SOFA scores, social/demographic data, and the Charlson Comorbidity Index were used to train a Random Forest model using the MIMIC-IV dataset, and then to externally validate it using the PSH dataset.FindingsOf 32,970 sepsis patients in the MIMIC-IV dataset, 6,824 (20.7%) died within 30 days. The model incorporating demographic, socioeconomic, and comorbidity data with SOFA scores showed improved predictive accuracy over SOFA parameters alone. Day 2 SOFA components were highly predictive, with additional factors like age, weight, and comorbidity enhancing prognostic precision. External validation demonstrated consistency in the model’s performance, with delta SOFA between days 1 and 3 emerging as a strong mortality predictor.ConclusionIntegrating patient-specific information with clinical measures significantly enhances the predictive accuracy for sepsis mortality. Our findings suggest the need for a multidimensional prognostic framework, considering both clinical and non-clinical patient information for a more accurate sepsis outcome prediction.

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“…The SOFA score ( Arakawa et al., 2021 ) refers to the Sequential Organ Failure Assessment, one of the most used scores in the ICU, and is often used to assess the severity of a patient’s condition. The APACHE II score ( Naved et al., 2011 ) consists of an acute physiology score, age score, and chronic health score and is a predictor of mortality in patients in the ICU.…”

Section: Methodsmentioning

confidence: 99%

Risk stratification and survival time of patients with gram-negative bacillary pneumonia in the intensive care unit

Liao,

Feng,

Zhuo

et al. 2024

Front. Cell. Infect. Microbiol.

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IntroductionPneumonia is a common infection in the intensive care unit (ICU), and gram-negative bacilli are the most common bacterial cause. The purpose of the study was to investigate the risk factors for 30-day mortality in patients with gram-negative bacillary pneumonia in the ICU, construct a predictive model, and stratify patients based on risk to assess their short-term survival.MethodsPatients admitted to the ICU with gram-negative bacillary pneumonia at Fujian Medical University Affiliated First Hospital between January 2018 and September 2020 were selected. Patients were divided into deceased and survivor groups based on whether death occurred within 30 days. Multifactorial logistic regression analysis was used to identify independent risk factors for 30-day mortality in these patients, and a predictive nomogram model was constructed based on these factors. Patients were categorized into low-, medium-, and high-risk groups according to the model's predicted probability, and Kaplan-Meier survival curves were plotted to assess short-term survival.ResultsThe study included 305 patients. Lactic acid (odds ratio [OR], 1.524, 95% CI: 1.057-2.197), tracheal intubation (OR: 4.202, 95% CI: 1.092-16.169), and acute kidney injury (OR:4.776, 95% CI: 1.632-13.978) were identified as independent risk factors for 30-day mortality. A nomogram prediction model was established based on these three factors. Internal validation of the model showed a Hosmer-Lemeshow test result of X2=5.770, P=0.834, and an area under the ROC curve of 0.791 (95% CI: 0.688-0.893). Bootstrap resampling of the original data 1000 times yielded a C-index of 0.791, and a decision curve analysis indicated a high net benefit when the threshold probability was between 15%-90%. The survival time for low-, medium-, and high-risk patients was 30 (30, 30), 30 (16.5, 30), and 17 (11, 27) days, respectively, which were significantly different.ConclusionLactic acid, tracheal intubation, and acute kidney injury were independent risk factors for 30-day mortality in patients in the ICU with gram-negative bacillary pneumonia. The predictive model constructed based on these factors showed good predictive performance and helped assess short-term survival, facilitating early intervention and treatment.

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A new SOFA score calculation to improve the predictive performance for mortality in sepsis-associated disseminated intravascular coagulopathy patients

Cited by 5 publications

References 24 publications

Predictive Value of New Sequential Organ Failure Assessment (SOFA) Score of Mortality in Critically Ill Patients in Emergency Department in Suez Canal University Hospital

Predictive Value of New Sequential Organ Failure Assessment (SOFA) Score of Mortality in Critically Ill Patients in Emergency Department in Suez Canal University Hospital

Integrating Social Determinants of Health with SOFA Scoring to Enhance Mortality Prediction in Septic Patients: A Multidimensional Prognostic Model

Risk stratification and survival time of patients with gram-negative bacillary pneumonia in the intensive care unit

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