The predictive power of SAPS-3 and SOFA scores and their relations with patient outcomes in the Surgical Intensive Care Unit

Abstract

Objective: Individual risk of surgical patients is more often underestimated and there is not an absolute criterion demonstrating which patient deserves intensive care. Since a nominative assessment of these patients to quantify the intensity of critical illness is not appropriate, prognostic scores are used to assess the mortality rate and prognosis for critical patients including surgical ones. This study aimed to test the calibration power of SAPS-3 score and SOFA score of surgical patients undergoing gastrointestinal surgery, and identify any relation with patient outcomes in the department of surgical ICU. Material and Methods: This retrospective observational study was conducted during the period between August 2017 and December 2017. It was performed at a Gastroenterological Surgical ICU, a tertiary care hospital in Ankara, Türkiye. To calculate SAPS-3 and SOFA score, physiological data and laboratory analysis on the day of ICU admission were used. Records were reviewed from hospitalization to medical discharge or hospital mortality. Statistical analysis included Mann Whitney U-test and ROC-curves to predict 30-day mortality. Results: A total of 233 patients admitted to the Gastroenterological Surgical ICU were included into the study and the main reason for ICU admission was surgical problems. Mortality rate was 2.6 % (6 patients). Average SAPS-3 score was 32.5 and SOFA score was 30.1. A significant correlation was observed with the SAPS-3 score, but not with the SOFA score statistically in mortality as a dependent factor. The discriminative power, assessed using the AUC and the probability of death estimation, was satisfactory with the SAPS-3 scores (AUC 0.754) while it was lower with the SOFA score (AUC 0.631) Conclusion: We found that SAPS-3 score was significantly correlated not only with mortality rate, but also with LOS in the ICU. Nonetheless, SOFA score was not related to mortality, but related to LOS in the ICU. Prognostic score systems are used to estimate mortality but they may be used to identify LOS in the ICU and postoperative complications. It can be concluded that SAPS-3 and SOFA scores may be used to prognosticate postoperative ICU requirement.

Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients

“…Similar results are published by Basile-Filho et al, who revealed an AUCROC of 0.79 by using the SOFA score for the prediction of mortality within 847 surgical ICU patients [32]. Contrarily, Mungan et al showed a lower predictive validity of 0.63 of the SOFA score in surgical ICU patients [33]. Although authors of these studies described their population as "surgical patients," it must be highlighted that their calculations comprised all kinds of surgical patients, independently of their risk for infection, including those without suspicion of infection.…”

Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients

“…Similar results are published by Basile-Filho et al, who revealed an AUCROC of 0.79 by using the SOFA score for the prediction of mortality within 847 surgical ICU patients [33]. Contrarily, Mungan et al showed a lower predictive validity of 0.63 of the SOFA score in surgical ICU patients [34]. Although authors of these studies described their population as "surgical patients", it must be highlighted that their calculations comprised all kinds of surgical patients, independently of their risk for infection, including those without suspicion of infection.…”

Comparison of qSOFA score, SOFA Score, and SIRS Criteria for the Prediction of Infection and Mortality Among Surgical Intermediate and Intensive Care Patients

“…Similar results are published by Basile-Filho et al, who revealed an AUCROC of 0.79 by using the SOFA score for the prediction of mortality within 847 surgical ICU patients [29]. Contrarily, Mungan et al showed a lower predictive validity of 0.63 of the SOFA score in surgical ICU patients [30]. Although authors of these studies described their population as "surgical patients", it must be highlighted that their calculations comprised all kinds of surgical patients, independently of their risk for infection, including those without suspicion of infection.…”