Mortality Prediction Using SOFA Score in Critically Ill Surgical and Non-Surgical Patients: Which Parameter Is the Most Valuable?

Abstract

Background and Objectives: assessment systems, such as the Sequential Organ Failure Assessment (SOFA) scale, are routinely used in intensive care units (ICUs) worldwide in order to predict patients’ outcome. We aimed to investigate SOFA’s usefulness in the prognostication of ICU mortality, including an analysis of the importance of its variables. Materials and Method: this single-centre observational study covered 905 patients that were admitted from 01.01.2015 to 31.12.2017 to a tertiary mixed ICU. The SOFA score was calculated on ICU admission. The worst results recorded within 24 h post admission were included into the calculation. The assessment was performed within subgroups of surgical (SP) and non-surgical patients (NSP). The subjects were followed-up until ICU discharge or death. ICU mortality was considered to be the outcome. Results: ICU mortality reached 35.4% (i.e., 320 deceased out of 905 ICU stays) and it was significantly lower in SP (n = 158, 25.3%) as compared with NSP (n = 162, 57.9%) (p < 0.001). A one-point increase in the SOFA score resulted in 1.35 times higher risk of death in the ICU in the whole studied population. Among the individual variables of SOFA, creatinine concentration was the most powerful in prognostication (OR = 1.92) in univariate analysis, while the Glasgow Coma Scale (GCS) score appeared to be the most important variable in multivariate analysis (OR = 1.8). Mortality prediction using consecutive SOFA variables differed between SP and NSP, as well as between men and women. Conclusions: The overall SOFA score predicts mortality to a similar extent in both surgical and non-surgical subjects. However, there are significant differences in prognostication using its particular components.

Haemogram-Derived Indices for Screening and Prognostication in Critically Ill Septic Shock Patients: A Case-Control Study

“…To improve screening, it has been suggested to assess them concomitantly with some well-known markers of systemic inflammation, including leucocytosis, C-Reactive Protein (CRP) or procalcitonin (PCT) [ 10 , 11 ]. To improve prognostication, they could be used in addition to some well-known ICU scorings, including APACHE II (Acute Physiology and Chronic Health Evaluation II), SAPS II (Simplified Acute Physiology Score II) and SOFA (Sequential Organ Failure Assessment) [ 12 , 13 ].…”

The prognostic nutritional index is associated with mortality of patients in intensive care unit

“…Patients followed in the ICU is a heterogeneous group with various complications and different clinical conditions, and it is known that the mortality rate of these patients is high. SOFA, one of the mortality estimation models used in the ICU, was first developed to determine the severity of organ dysfunction in septic patients, but later it was determined that it could also be an indicator of disease severity in critically ill patients in ICU, and it started to be used as a mortality indicator in recent years [14][15][16]. In our study, expectedly, the SOFA score was higher in the non-survivor group.…”

Brain natriuretic peptide and cardiac troponin I for prediction of the prognosis in cancer patients with sepsis

“…This study also found that the SOFA score and 72 hr fluid balance were independent risk factors for mortality in these patients. SOFA score is a reliable indicator to assess the severity of critical ill patients [22,23]. Its predictive value for the mortality of patients with sepsis has been confirmed by a large number of studies and would not be discussed further here [24,25].…”