Accuracy of the Sequential Organ Failure Assessment Score for In-Hospital Mortality by Race and Relevance to Crisis Standards of Care

Objective: To compare the discriminative value of the quick-sequential organ failure assessment score (qSOFA) to SOFA in a critically ill population, in which a microbial pathogen was isolated within 48 hours of admission to intensive care. Design: Retrospective cohort study. Setting: Academic tertiary referral center from July 2008 to June 2017. Patients: Hospitalized patients admitted to intensive care unit. Interventions: None. Measurements and Main Results: The primary outcome was in-hospital mortality for all patients with confirmed positive microbiological cultures within 48 hours of admission to intensive care unit (ICU). Subgroup analysis was performed on patients with pathogenic bacteremia or positive cultures in cerebrospinal fluid. Of the 11 415 patients analyzed with positive microbiology specimens within 48 hours of admission, 2933 (25.7%) had a qSOFA ≥2. Of these, 16.6% reached the primary outcome of in-hospital mortality. Unsurprisingly, the discriminative value of qSOFA on admission was significantly worse than that of SOFA (0.73 vs 0.76; P = .0004), despite observing a significant association between qSOFA category and in-hospital mortality ( P < .0001). In secondary analyses, similar observations were found using qSOFA within 6 and 24 hours of ICU admission. When analysis was focused on patients with pathogenic bacteremia or positive cerebrospinal fluid (CSF) cultures (n = 1646), there was no significant difference between the discriminative value of qSOFA and SOFA (0.75 vs 0.78; P = .17). Conclusions: Quick-sequential organ failure assessment score at admission was not superior to SOFA in predicting in-hospital mortality in patients with positive clinical cultures within 48 hours of admission to ICU. Quick-sequential organ failure assessment score at admission to the ICU was associated with mortality and showed reasonable calibration and discrimination. When the analysis was focused on patients with pathogenic bacteremia or positive CSF cultures, qSOFA performed similarly to SOFA in discriminatory those who will die from sepsis.

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A HIGH SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE PREDICTS HOSPITAL MORTALITY FOR LIVER TRANSPLANTATION RECIPIENTS

Transplantation Journal ◽

10.1097/00007890-201007272-01562 ◽

2010 ◽

Vol 90 ◽

pp. 802

Author(s):

W. Lee ◽

C. Lee ◽

T. Wu ◽

H. Chou ◽

K. Chan

Keyword(s):

Liver Transplantation ◽

Hospital Mortality ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Assessment Score ◽

Failure Assessment

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Prehospital quick sequential organ failure assessment score to predict in-hospital mortality among patients with trauma

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2019.03.007 ◽

2019 ◽

Vol 37 (12) ◽

pp. 2165-2170 ◽

Cited By ~ 1

Author(s):

Kyohei Miyamoto ◽

Naoaki Shibata ◽

Atsuhiro Ogawa ◽

Tsuyoshi Nakashima ◽

Seiya Kato

Keyword(s):

Hospital Mortality ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Assessment Score ◽

Failure Assessment

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A Modified Sequential Organ Failure Assessment Score to Predict Hospital Mortality of Postoperative Acute Renal Failure Patients Requiring Renal Replacement Therapy

Blood Purification ◽

10.1159/000178771 ◽

2008 ◽

Vol 26 (6) ◽

pp. 547-554 ◽

Cited By ~ 15

Author(s):

Yu-Feng Lin ◽

Wen-Je Ko ◽

Vin-Cent Wu ◽

Yih-Sharng Chen ◽

Yung-Ming Chen ◽

...

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Renal Replacement Therapy ◽

Hospital Mortality ◽

Sequential Organ Failure Assessment ◽

Replacement Therapy ◽

Organ Failure ◽

Assessment Score ◽

Failure Assessment ◽

Predict Hospital Mortality

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Risk factors of in-hospital mortality in adult postcardiotomy cardiogenic shock patients successfully weaned from venoarterial extracorporeal membrane oxygenation

Perfusion ◽

10.1177/0267659119890214 ◽

2019 ◽

Vol 35 (5) ◽

pp. 417-426

Author(s):

Haixiu Xie ◽

Feng Yang ◽

Dengbang Hou ◽

Xiaomeng Wang ◽

Liangshan Wang ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Hospital Mortality ◽

Cardiogenic Shock ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Assessment Score ◽

Membrane Oxygenation ◽

Venoarterial Extracorporeal Membrane Oxygenation ◽

Failure Assessment ◽

Postcardiotomy Cardiogenic Shock

Objective: Mortality of adult postcardiotomy cardiogenic shock patients after successfully weaned from venoarterial extracorporeal membrane oxygenation remains high. The objective of this study is to identify the risk factors associated with mortality after successfully weaning from venoarterial extracorporeal membrane oxygenation in adult postcardiotomy cardiogenic shock patients. Methods: All consecutive patients who were successfully weaned from venoarterial extracorporeal membrane oxygenation between January 2011 and December 2016 at the Beijing Anzhen Hospital were analyzed retrospectively. Multivariate logistic regression was performed to identify risk factors associated with in-hospital mortality after successfully weaning from venoarterial extracorporeal membrane oxygenation. Results: In total, 212 (58.4%) of 363 postcardiotomy cardiogenic shock patients were successfully weaned from venoarterial extracorporeal membrane oxygenation. The non-survivors had a longer duration of extracorporeal membrane oxygenation than the survivors (120.0 (98.0, 160.50) vs. 100.0 (77.0, 126.0), p = 0.000). Variables associated with mortality of patients successfully weaned from extracorporeal membrane oxygenation by univariable analysis were age, diabetes, vasoactive inotropic score pre-extracorporeal membrane oxygenation, vasoactive inotropic score at weaning, left ventricular ejection fraction at weaning, central venous pressure at weaning, sequential organ failure assessment score pre-extracorporeal membrane oxygenation, sequential organ failure assessment at weaning, survival after venoarterial ECMO pre-extracorporeal membrane oxygenation, and survival after venoarterial ECMO at weaning. In the multivariate analysis, sequential organ failure assessment score at weaning (odds ratio = 1.889, 95% confidence interval = 1.460-2.455, p < 0.001) was an independent risk factor for in-hospital mortality of patients successfully weaned from venoarterial extracorporeal membrane oxygenation. The cumulative 30-day survival rate in patients with a sequential organ failure assessment score < 7 was significantly ( p < 0.001) higher than in patients with a sequential organ failure assessment score ⩾ 7 (87% vs. 56.7%, p < 0.001). Conclusion: Vasoactive inotropic score, left ventricular ejection fraction, central venous pressure, and sequential organ failure assessment score at weaning were associated with in-hospital mortality for postcardiotomy cardiogenic shock patients successfully weaned from venoarterial extracorporeal membrane oxygenation. Sequential organ failure assessment score might help clinicians to predict in-hospital mortality for patients successfully weaned from venoarterial extracorporeal membrane oxygenation.

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Alcoholic liver disease on the intensive care unit – Outcomes and prognostication

Journal of the Intensive Care Society ◽

10.1177/1751143716662055 ◽

2016 ◽

Vol 18 (1) ◽

pp. 24-29 ◽

Cited By ~ 2

Author(s):

James I Beck ◽

Anca Staicu ◽

Simon M Everett ◽

Phil Jackson

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Liver Disease ◽

Intensive Care Unit Admission ◽

Hospital Mortality ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Alcoholic Liver Disease ◽

Assessment Score ◽

Failure Assessment

Background Hospital admissions with decompensated chronic alcoholic liver disease have been increasing, leading to increased pressure on intensive care unit services. We aimed to determine the outcome and prognostic factors for patients with alcoholic liver disease requiring admission to intensive care unit. Methods This was a retrospective study over 5 years (January 2006–December 2010) of all intensive care unit admissions with alcoholic liver disease to either of the two Leeds Teaching Hospitals NHS Trust general intensive care units. A detailed case note review was conducted based on a pre-established proforma. Eighty-two patients included. Primary outcome was hospital mortality. Results The overall intensive care unit and hospital mortality were 46% and 67%, respectively. Hospital mortality in patients successfully discharged from intensive care unit with the intent of recovery remained high at 21%. Variceal bleed was the only indicator that had a mortality <60%. Factors which suggested a poor outcome included sepsis (86% mortality) and hepato-renal syndrome (86% mortality). A Sequential Organ Failure Assessment score of greater than 10 on intensive care unit admission was associated with 97% hospital mortality. Sequential Organ Failure Assessment score increased from a mean of 10.9–12.5 in those that did not survive hospital. Patients with first alcoholic liver disease related admission had poorer outcomes. Conclusion These results are similar to previous studies with no significant improvement in outcomes. Alcoholic liver disease is not a contra-indication to intensive care unit admission but assessment of the individual patient is required. The most appropriate objective factors to guide prognostication are the presenting intensive care unit diagnosis and Sequential Organ Failure Assessment score. First presentation of alcoholic liver disease is not a positive prognostic indicator.

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