Predictive performance of the SOFA and mSOFA scoring systems for predicting in-hospital mortality in the emergency department

Rahmatinejad, Zahra; Reihani, Hamidreza; Tohidinezhad, Fariba; Rahmatinejad, Fatemeh; Peyravi, Samira; Pourmand, Ali; Abu‐Hanna, Ameen; Eslami, Saeid

doi:10.1016/j.ajem.2018.09.011

Cited by 33 publications

(29 citation statements)

References 24 publications

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“…38 These results are consistent with our findings in determining the predictive value of the SOFA score for prognosis of patients with severe AIS. While the AUCs of the SOFA scoring system reported in various studies ranged from 0.70 to 0.87, [39][40][41] we showed similar values between 0.722 to 0.866 in our study.…”

Section: Discussionsupporting

confidence: 77%

Predictive value of the sequential organ failure assessment (SOFA) score for prognosis in patients with severe acute ischemic stroke: a retrospective study

et al. 2020

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Objective To identify the risk factors for early death and determine the predictive value of the sequential organ failure assessment (SOFA) score for prognosis of severe acute ischemic stroke (AIS). Methods A total of 110 patients with severe AIS were enrolled and divided into the non-survivor (n = 34) and survivor groups (n = 76). Logistic regression analysis was conducted to identify risk factors for early death, while the receiver operator characteristic (ROC) curve was used to determine the predictive effect of the SOFA score on prognosis. Results Logistic regression analysis showed that urinary tract infection (odds ratio [OR] = 17.364, 95% confidence interval [CI]: 1.903–158.427), mechanical ventilation (OR = 1.754, 95% CI: 1.648–2.219), and osmotic therapy (OR = 2.835, 95% CI: 1.871–5.102) were significantly correlated with early death of severe AIS. ROC curve analysis of the area under the curve after hospitalization showed that the maximum SOFA and ΔSOFA scores exceeded 0.7. Conclusion Our study shows that urinary tract infection, mechanical ventilation, and osmotic therapy are risk factors for early death of severe AIS. The SOFA score has good predictive value for prognosis of severe AIS. These findings may provide a guideline for improving clinical outcome.

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Section: Discussionsupporting

confidence: 77%

Predictive value of the sequential organ failure assessment (SOFA) score for prognosis in patients with severe acute ischemic stroke: a retrospective study

et al. 2020

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“…Earlier studies have used, for example, discharge diagnoses, single organ failure scoring system or modified 2001 sepsis consensus organ failure definitions 8–11 51. Recently, most studies present organ failure data based on the SOFA Score,24 25 but some of the values are not clinical applicable to the ED, and this have led to almost equal attempts to modify the SOFA Score to fit the different ED settings in studies conducted 42 52 53. These approaches are almost identical to our modified organ failure definitions, but the circulatory and respiratory differs slightly from study to study due to differences in accessible information in different ED settings.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

et al. 2019

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ObjectivesThe aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.DesignThis was a population-based cohort study of all citizens in four municipalities (population of 230 000 adults).SettingEmergency department at Odense University Hospital, Denmark.ParticipantsWe included all adult patients who arrived from 1 April 2012 to 31 March 2015.Primary and secondary outcome measuresOrgan failure was defined as a modified Sequential Organ Failure Assessment score≥2 within six possible organ systems: cerebral, circulatory, renal, respiratory, hepatic and coagulation.The primary outcome was prevalence of organ failure, and secondary outcomes were 0–7 days, 8–30 days and 31–365 days all-cause mortality.ResultsWe identified in total 175 278 contacts, of which 70 399 contacts were further evaluated for organ failure. Fifty-two per cent of these were women, median age 62 (IQR 42–77) years. The incidence of new organ failure was 1342/100 000 person-years, corresponding to 5.2% of all emergency department contacts.The 0–7-day, 8–30-day and 31–365-day mortality was 11.0% (95% CI: 10.2% to 11.8%), 5.6% (95% CI: 5.1% to 6.2%) and 13.2% (95% CI: 12.3% to 14.1%), respectively, if the patient had one or more new organ failures at first contact in the observation period, compared with 1.4% (95% CI: 1.3% to 1.6%), 1.2% (95% CI: 1.1% to 1.3%) and 5.2% (95% CI: 5.0% to 5.4%) for patients without. Seven-day mortality ranged from hepatic failure, 6.5% (95% CI: 4.9% to 8.6%), to cerebral failure, 33.8% (95% CI: 31.0% to 36.8%), the 8–30-day mortality ranged from cerebral failure, 3.9% (95% CI: 2.8% to 5.3%), to hepatic failure, 8.6% (95% CI: 6.6% to 10.8%) and 31–365-day mortality ranged from cerebral failure, 9.3% (95% CI: 7.6% to 11.2%), to renal failure, 18.2% (95% CI: 15.5% to 21.1%).ConclusionsThe study revealed an incidence of new organ failure at 1342/100 000 person-years and a prevalence of 5.2% of all emergency department contacts. One-year all-cause mortality was 29.8% among organ failure patients.

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“…Moreover, in retrospective studies, complex scores such as APACHE II or SOFA are likely to be unhelpful due to missing values. We used the modified SOFA (mSOFA) score to limit the impact on missing variables, due to the retrospective nature of our study [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…We could not calculate this variable in patients for whom WBC counts were within or below normal range during the entire study period. To define sepsis, we used a modified sequential organ failure assessment (mSOFA) to overcome the limitations due to missing values [ 22 , 23 ]. A serial mSOFA was calculated on days 1, 3, 5, and 7 with the most abnormal values in the 24-h period.…”

Section: Methodsmentioning

confidence: 99%

Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study

et al. 2020

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The impact of adjusted treatment on clinical outcomes in patients with severe obesity is unclear. This study included adults with severe obesity admitted for bloodstream infections between 2005 and 2015. The patients were grouped according to the percentage of the appropriateness of the dosage of their antimicrobial treatment: 80–100% = good, 20–79% = moderate, and 0–19% = poor. The association between antimicrobial adjustment and a composite of unfavourable outcomes [intensive care unit stay ≥72 h, duration of sepsis >3 days, length of stay ≥7 days or all-cause 30-day mortality] was assessed using logistic regression. Of 110 included episodes, the adjustment was rated good in 47 (43%) episodes, moderate in 31 (28%), and poor in 32 (29%). Older age, Pitt bacteremia score ≥2, sepsis on day 1, and infection site were independent risk factors for unfavourable outcomes. The level of appropriateness was not associated with unfavourable outcomes. The number of antimicrobials, consultation with an infectious disease specialist, blood urea nitrogen 7–10.9 mmol/L, and hemodialysis were significantly associated with adjusted antimicrobial dosing. While the severity of the infection had a substantial impact on the measured outcomes, we did not find an association between dosing optimization and better outcomes.

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Predictive performance of the SOFA and mSOFA scoring systems for predicting in-hospital mortality in the emergency department

Cited by 33 publications

References 24 publications

Predictive value of the sequential organ failure assessment (SOFA) score for prognosis in patients with severe acute ischemic stroke: a retrospective study

Predictive value of the sequential organ failure assessment (SOFA) score for prognosis in patients with severe acute ischemic stroke: a retrospective study

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

Is Antimicrobial Dosing Adjustment Associated with Better Outcomes in Patients with Severe Obesity and Bloodstream Infections? An Exploratory Study

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