Predictive performance of the sequential organ failure assessment score for in‐hospital mortality in patients with end‐stage kidney disease in intensive care units: A multicenter registry in Japan

Abstract

IntroductionThere is limited evidence regarding whether the performance of the Sequential Organ Failure Assessment (SOFA) score differs between patients with and without end‐stage kidney disease (ESKD) in intensive care units (ICUs).MethodsWe used a multicenter registry (Japanese Intensive care Patient Database) to enroll adult ICU patients between April 2018 and March 2021. We recalibrated the SOFA score using a logistic regression model and evaluated its predictive ability in both ESKD and non‐ESKD groups. The primary outcome was in‐hospital mortality.Results128 134 patients were enrolled. The AUROC of the SOFA score was lower in the ESKD group than in the non‐ESKD group [0.789 (95% CI, 0.774–0.804) vs. 0.846 (95% CI, 0.841–0.850)]. The calibration plot revealed good performance in both groups. However, it overestimated in‐hospital mortality in ESKD groups.ConclusionThe SOFA score demonstrated good predictive ability in patients with and without ESKD, but it overestimated the in‐hospital mortality in ESKD patients.