Evaluation of Sequential Organ Failure Assessment (SOFA) Performance in Neurocritical Care Patients Overtime: A Retrospective Cohort Study (original) (raw)
Related papers
Scientifica, 2016
Background. The sequential organ failure assessment (SOFA) score has been recommended to triage critically ill patients in the intensive care unit (ICU). This study aimed to compare the performance of our proposed MSOFA and original SOFA scores in predicting ICU mortality. Methods. This prospective observational study was conducted on 250 patients admitted to the ICU. Both tools scores were calculated at the beginning, 24 hours of ICU admission, and 48 hours of ICU admission. Diagnostic odds ratio and receiver operating characteristic (ROC) curve were used to compare the two scores. Results. MSOFA and SOFA predicted mortality similarly with an area under the ROC curve of 0.837, 0.992, and 0.977 for MSOFA 1, MSOFA 2, and MSOFA 3, respectively, and 0.857, 0.988, and 0.988 for SOFA 1, SOFA 2, and SOFA 3, respectively. The sensitivity and specificity of MSOFA 1 in cut-off point 8 were 82.9% and 68.4%, respectively, MSOFA 2 in cut-off point 9.5 were 94.7% and 97.1%, respectively, and MSO...
Indian Journal of Critical Care Medicine
Aim and objective: To examine if sequential organ failure assessment (SOFA) alone or SOFA in combination with pH is a better prognosis and mortality indicator. Materials and methods: We conducted a prospective observational study in a total of sixty patients. The mortality of patients was predicted on the basis of a SOFA score alone or SOFA score in combination with pH, and the prediction by both was compared to the actual outcome. The comparison was based on the "standardized mortality ratio" and the "area under the receiver operating characteristic curve (AUROC). " Result: At the time of admission, both the scores (SOFA and SOFA with pH) were equally effective in predicting mortality. At 48 hours, SOFA with pH proves to be slightly better in mortality prediction than SOFA score alone. The discriminative power of both the scores was assessed by calculating AUROC. AUROC of the SOFA score was better than that of SOFA with pH at admission and at 48 hours, but statistically, both had the same level of discrimination, i.e., excellent. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were the same for both the scores at admission, but all parameters except specificity were better for SOFA with pH at 48 hours. Specificity was the same for both even at 48 hours. Conclusion: At the time of admission, SOFA score and SOFA with pH were equally effective in outcome prediction, but after 48 hours, SOFA with pH proves to be better than the SOFA score alone. The power of discrimination is the same for both the scores at admission and at 48 hours.
Journal of Anaesthesiology Clinical Pharmacology, 2015
Background and Aims: The objective was to determine the accuracy of sequential organ failure assessment (SOFA) score in predicting outcome of patients in Intensive Care Unit (ICU). Material and Methods: Forty-four consecutive patients between 15 and 80 years admitted to ICU over 8 weeks period were studied prospectively. Three patients were excluded. SOFA score was determined 24 h postadmission to ICU and subsequently every 48 h for the first 10 days. Patients were followed till discharge/death/transfer from the ICU. Initial SOFA score, highest and mean SOFA scores were calculated and correlated with mortality and duration of stay in ICU. Results: The mortality rate was 39% and the mean duration of stay in the ICU was 9 days. The maximum score in survivors (3.92 ± 2.17) was significantly lower than nonsurvivors (8.9 ± 3.45). The initial SOFA score had a strong statistical correlation with mortality. Cardiovascular score on day 1 and 3, respiratory score on day 7, and coagulation profile on day 3 correlated significantly with the outcome. Duration of the stay did not correlate with the survival (P = 0.461). Conclusion: SOFA score is a simple, but effective prognostic indicator and evaluator for patient progress in ICU. Day 1 SOFA can triage the patients into risk categories. For further management, mean and maximum score help determine the severity of illness and can act as a guide for the intensity of therapy required for each patient.
Journal of Critical Care, 2012
This study aims to validate the performance of the Sequential Organ Failure Assessment (SOFA) score to predict death of critically ill patients with cancer. Material and methods: We conducted a retrospective observational study including adults admitted to the intensive care unit (ICU) between January 1, 2006, and December 31, 2008. We randomly selected training and validation samples in medical and surgical admissions to predict ICU and in-hospital mortality. By using logistic regression, we calculated the probabilities of death in the training samples and applied them to the validation samples to test the goodness-of-fit of the models, construct receiver operator characteristics curves, and calculate the areas under the curve (AUCs). Results: In predicting mortality at discharge from the unit, the AUC from the validation group of medical admissions was 0.7851 (95% confidence interval [CI], 0.7437-0.8264), and the AUC from the surgical admissions was 0.7847 (95% CI, 0.6319-0.937). The AUCs of the SOFA score to predict mortality in the hospital after ICU admission were 0.7789 (95% CI, 0.74-0.8177) and 0.7572 (95% CI, 0.6719-0.8424) for the medical and surgical validations groups, respectively. Conclusions: The SOFA score had good discrimination to predict ICU and hospital mortality. However, the observed underestimation of ICU deaths and unsatisfactory goodness-of-fit test of the ☆ This study was performed at the
Critical care medicine, 2015
Prediction models for ICU mortality rely heavily on physiologic variables that may not be available in large retrospective studies. An alternative approach when physiologic variables are absent stratifies mortality risk by acute organ failure classification. Retrospective cohort study. Two large teaching hospitals in Boston, MA. Ninety-two thousand eight hundred eighty-six patients aged 18 years old or older admitted between November 3, 1997, and February 25, 2011, who received critical care. None. The derivation cohort consisted of 35,566 patients from Brigham and Women's Hospital, and the validation cohort comprised 57,320 patients from Massachusetts General Hospital. Acute organ failure was determined for each patient based on International Classification of Diseases, 9th Revision, Clinical Modification code combinations. The main outcome measure was 30-day mortality. A clinical prediction model was created based on a logistic regression model describing the risk of 30-day mo...
International Journal of Medicine and Public Health, 2013
Introduction: Sepsis is one of the most important causes of mortality in the intensive care setting. An effective predictor of prognosis of sepsis is required to assess morbidity and mortality of this condition. In this study, sepsis in the intensive care unit (ICU) of a tertiary care hospital was evaluated, with specifi c reference to clinical features and causative organisms. The sequential organ failure assessment (SOFA) score was calculated to assess the severity of sepsis and multi-organ failure at presentation and after 48 h. The correlation of SOFA and mean SOFA scores with outcome was studied. Materials and Methods: This was a prospective, observational, cohort study carried out in a tertiary care teaching hospital. Forty consecutive cases of septicemia were studied. Detailed history, clinical features, and SOFA score was recorded to assess the disease severity at the time of presentation and after 48 h. Inclusion of patients in the study was performed using the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) defi nition of sepsis. Two sample t-test and 95% confi dence interval (CI) for difference of mean was applied. Results: When the SOFA score was <7, the mortality was 56%. It increased to 70% when the score was 8-15 (P = 0.0989, t value: 1.69, Mean difference: 2.12, 95% CI: 0.41-4.665). Patients with SOFA score <7 after 48 h had 52% mortality and it increased to 88% when the score was 8-15. The mean SOFA score at 48 h was 6.96 in patients who died and 2.5 in those who improved (P < 0.001, t value: 4.332, mean difference: 4.39, 95% CI: 2.34-6.44). Hence, the predictive value for mortality of SOFA score was better at 48 h than at presentation. Conclusions: Sequential assessment of organ dysfunction in ICU at presentation and at 48 h is a good indicator of prognosis. Both mean and highest SOFA scores are particularly useful predictors of outcome, independent of the initial score. A high SOFA score at 48 h of presentation predicts an increased mortality rate.
A Study on Mortality Outcomes in ICU Patients with Sequential Organ Failure Assessment (SOFA) Score
2015
PURPOSE OF THE PROJECT: This study intends to evaluate the usefulness of sequential organ failure assessment score (SOFA) in assessing organ dysfunction and risk of mortality in patients admitted to ICU. BACKGROUND: Outcome prediction is important in both clinical and administrative ICU management. It can be usefully applied to monitor the progress of an individual ICU. It also provides useful information on likely patient outcomes for critically ill patients and also for therapeutic decision making and using available resources efficiently. In an ICU setting serial organ function monitoring is important since there is a time to time variation in the general condition of the patient. Sequential Organ Failure Assessment (SOFA) is one such outcome prediction model to assess prognosis and mortality risk in ICU patients. DATA COLLECTION AND THE SOURCE: All adult patients admitted to the intensive care unit of Coimbatore Medical College Hospital will be included in the study. Blood sampl...
The Journals of Gerontology: Series A, 2013
Background. Several tools to predict patients' survival have been proposed in medical wards, though they are often time consuming and difficult to apply. The Sequential Organ Failure Assessment (SOFA) is a promising tool that has been validated in intensive care units but never in acute medical wards. The aim of this study was to assess whether the SOFA score predicts short-term (30 days) mortality in a population of elderly patients admitted to a geriatric ward. Methods. This prospective observational cohort study was carried out in a Geriatric Clinic of an Italian teaching hospital. Among 359 patients consecutively and firstly admitted between January and April 2012, we considered eligible those (n = 314) directly admitted from the emergency department. Demographic, functional, and clinical variables were collected. The SOFA score was measured on admission (SOFA-admission) and 48 hours later (SOFA-48h). The vital status of participants was assessed over the 30 days following discharge. Results. Patients who died at 1-month follow-up were prevalently men, more comorbid, disabled, and undernourished and had higher SOFA scores on admission and at 48 hours than their counterparts. Among all potential predictors of 1-month mortality, the SOFA-48h score was the best, with a score greater than 4 significantly increasing the risk to die during hospitalization or in the 30 days following discharge (odds ratio = 7.030; 95% confidence interval = 3.982-12.409). Conclusions. The SOFA score, a user-friendly tool used in intensive care units to estimate prognosis, is able to predict 1-month mortality also in patients admitted to an acute geriatric setting.
The Sequential Organ Failure Assessment (SOFA) Score: has the time come for an update?
Critical Care, 2023
The Sequential Organ Failure Assessment (SOFA) score was developed more than 25 years ago to provide a simple method of assessing and monitoring organ dysfunction in critically ill patients. Changes in clinical practice over the last few decades, with new interventions and a greater focus on non-invasive monitoring systems, mean it is time to update the SOFA score. As a first step in this process, we propose some possible new variables that could be included in a SOFA 2.0. By so doing, we hope to stimulate debate and discussion to move toward a new, properly validated score that will be fit for modern practice.