Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Argyriou, George; Vrettou, Charikleia; Filippatos, Gerasimos; Sainis, George; Nanas, Serafim; Routsi, Christina

doi:10.1016/j.jcrc.2015.04.014

Cited by 26 publications

(30 citation statements)

References 40 publications

(53 reference statements)

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“…Similar to our study, Argyriou et al demonstrated equivalent discrimination for day 1 SOFA score and the older APACHE‐II score . The population in the study by Argyriou et al had double the prevalence of acute coronary syndromes (two thirds versus one third in our population), and a markedly higher mortality rate both in the CICU (18.3% versus 5.6%) and hospital (23.7% versus 9.1%), despite a modestly higher mean SOFA score (4.1 versus 3.5) . Unlike the study by Argyriou et al, 14 we examined long‐term outcomes, allowing us to report a novel association between day 1 SOFA score and postdischarge survival.…”

Section: Discussionsupporting

confidence: 87%

“…The only other published study we identified examining the SOFA score in patients in the CICU was recently reported by Argyriou et al . This small study of 300 patients in the CICU from Greece during 2010 through 2012 showed excellent discrimination of the day 1 SOFA score for CICU mortality (AUROC, 0.88) and hospital mortality (AUROC, 0.90), compared with AUROC values in the present study of 0.85 and 0.83, respectively . Similar to our study, Argyriou et al demonstrated equivalent discrimination for day 1 SOFA score and the older APACHE‐II score .…”

Section: Discussionsupporting

confidence: 87%

“…This small study of 300 patients in the CICU from Greece during 2010 through 2012 showed excellent discrimination of the day 1 SOFA score for CICU mortality (AUROC, 0.88) and hospital mortality (AUROC, 0.90), compared with AUROC values in the present study of 0.85 and 0.83, respectively . Similar to our study, Argyriou et al demonstrated equivalent discrimination for day 1 SOFA score and the older APACHE‐II score . The population in the study by Argyriou et al had double the prevalence of acute coronary syndromes (two thirds versus one third in our population), and a markedly higher mortality rate both in the CICU (18.3% versus 5.6%) and hospital (23.7% versus 9.1%), despite a modestly higher mean SOFA score (4.1 versus 3.5) .…”

Section: Discussionsupporting

confidence: 86%

“…The most important advantages of the SOFA score remain the simplicity and ease of use, allowing calculation at the bedside, with mortality discrimination similar to more complex scores . The SOFA score can be calculated daily, and changes over time have important prognostic relevance .…”

Section: Discussionmentioning

confidence: 99%

“…In patients with sepsis, a SOFA score ≥2 reflects clinically relevant organ dysfunction and an increased risk of adverse outcomes . The SOFA score has been validated in critically ill patients with diseases other than sepsis, including a small CICU population . Advantages of the SOFA score compared with other ICU risk scores include its simplicity and ease of use, allowing it to be calculated daily at bedside without complex algorithms to demonstrate clinical improvement or deterioration over time.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population

Jentzer

Bennett

Wiley

et al. 2018

JAHA

129

147

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BackgroundOptimal methods of mortality risk stratification in patients in the cardiac intensive care unit (CICU) remain uncertain. We evaluated the ability of the Sequential Organ Failure Assessment (SOFA) score to predict mortality in a large cohort of unselected patients in the CICU.Methods and ResultsAdult patients admitted to the CICU from January 1, 2007, to December 31, 2015, at a single tertiary care hospital were retrospectively reviewed. SOFA scores were calculated daily, and Acute Physiology and Chronic Health Evaluation (APACHE)‐III and APACHE‐IV scores were calculated on CICU day 1. Discrimination of hospital mortality was assessed using area under the receiver‐operator characteristic curve values. We included 9961 patients, with a mean age of 67.5±15.2 years; all‐cause hospital mortality was 9.0%. Day 1 SOFA score predicted hospital mortality, with an area under the receiver‐operator characteristic curve value of 0.83; area under the receiver‐operator characteristic curve values were similar for the APACHE‐III score, and APACHE‐IV predicted mortality (P>0.05). Mean and maximum SOFA scores over multiple CICU days had greater discrimination for hospital mortality (P<0.01). Patients with an increasing SOFA score from day 1 and day 2 had higher mortality. Patients with day 1 SOFA score <2 were at low risk of mortality. Increasing tertiles of day 1 SOFA score predicted higher long‐term mortality (P<0.001 by log‐rank test).ConclusionsThe day 1 SOFA score has good discrimination for short‐term mortality in unselected patients in the CICU, which is comparable to APACHE‐III and APACHE‐IV. Advantages of the SOFA score over APACHE include simplicity, improved discrimination using serial scores, and prediction of long‐term mortality.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population

Jentzer

Bennett

Wiley

et al. 2018

JAHA

129

147

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Early noncardiovascular organ failure and mortality in the cardiac intensive care unit

Jentzer

Wiley

Bennett

et al. 2020

Clinical Cardiology

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Background: Noncardiac organ failure has been associated with worse outcomes among a cardiac intensive care unit (CICU) population.Hypothesis: We hypothesized that early organ failure based on the sequential organ failure assessment (SOFA) score would be associated with mortality in CICU patients.Methods: Adult CICU patients from 2007 to 2015 were reviewed. Organ failure was defined as any SOFA organ subscore ≥3 on the first CICU day. Organ failure was evaluated as a predictor of hospital mortality and postdischarge survival after adjustment for illness severity and comorbidities.Results: We included 10 004 patients with a mean age of 67 ± 15 years (37% female). Admission diagnoses included acute coronary syndrome in 43%, heart failure in 46%, cardiac arrest in 12%, and cardiogenic shock in 11%. Organ failure was present in 31%, including multiorgan failure in 12%. Hospital mortality was higher in patients with organ failure (22% vs 3%, adjusted OR 3.0, 95% CI 2.5-3.7, P < .001).After adjustment, each failing organ system predicted twofold higher odds of hospital mortality (adjusted OR 1.9, 95% CI 1.1-2.1, P < .001). Mortality risk was highest with cardiovascular, coagulation and liver failure. Among hospital survivors, organ failure was associated with higher adjusted postdischarge mortality risk (P < .001); multiorgan failure did not confer added long-term mortality risk.Conclusions: Early noncardiovascular organ failure, especially multiorgan failure, is associated with increased hospital mortality in CICU patients, and this risk continues Abbreviations: APACHE, acute physiology and chronic health evaluation; BMI, body mass index; CCI, Charlson comorbidity index; CI, confidence interval; CICU, cardiac intensive care unit; IABP, intra-aortic balloon pump; LOS, length of stay; OASIS, Oxford Acute Severity of Illness Score; OR, odds ratio; PAC, pulmonary artery catheter; PCI, percutaneous coronary intervention; SOFA, sequential organ failure assessment.

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Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population

Jentzer

Diepen

Murphree

et al. 2020

American Heart Journal

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Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit

Cited by 26 publications

References 40 publications

Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population

Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population

Early noncardiovascular organ failure and mortality in the cardiac intensive care unit

Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population

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