Sequential Organ Failure Assessment (SOFA) and 90-day mortality in patients with kidney transplant status at first ICU admission: a cohort study of 428 patients

BackgroundThe clinical benefit of implementing the quick Sepsis-related Organ Failure Assessment (qSOFA) instead of early warning scores (EWS) to screen all hospitalised patients for critical illness has yet to be investigated in a large, multicentre study.MethodsWe conducted a cohort study including all hospitalised patients ≥18 years with EWS recorded at hospitals in the Central Denmark Region during the year 2016. The primary outcome was intensive care unit (ICU) admission and/or death within 2 days following an initial EWS. Prognostic accuracy was examined using sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). Discriminative accuracy was examined by the area under the receiver operating characteristic curve (AUROC).ResultsAmong 97 332 evaluated patients, 1714 (1.8%) experienced the primary outcome. The qSOFA ≥2 was less sensitive (11.7% (95% CI: 10.2% to 13.3%) vs 25.1% (95% CI: 23.1% to 27.3%)) and more specific (99.3% (95% CI: 99.2% to 99.3%) vs 97.5% (95% CI: 97.4% to 97.6%)) than EWS ≥5. The NPV was similar for the two scores (EWS ≥5, 98.6% (95% CI: 98.6% to 98.7%) and qSOFA ≥2, 98.4% (95% CI: 98.3% to 98.5%)), while the PPV was 15.1% (95% CI: 13.8% to 16.5%) for EWS ≥5 and 22.4% (95% CI: 19.7% to 25.3%) for qSOFA ≥2. The AUROC was 0.72 (95% CI: 0.70 to 0.73) for EWS and 0.66 (95% CI: 0.65 to 0.67) for qSOFA.ConclusionThe qSOFA was less sensitive (qSOFA ≥2 vs EWS ≥5) and discriminatively accurate than the EWS for predicting ICU admission and/or death within 2 days after an initial EWS. This study did not support replacing EWS with qSOFA in all hospitalised patients.

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Comparison of Proposed Modified and Original Sequential Organ Failure Assessment Scores in Predicting ICU Mortality: A Prospective, Observational, Follow-Up Study

Scientifica ◽

10.1155/2016/7379325 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Afshin Gholipour Baradari ◽

Hassan Sharifi ◽

Abolfazl Firouzian ◽

Maryam Daneshiyan ◽

Mohsen Aarabi ◽

...

Keyword(s):

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Sensitivity And Specificity ◽

Roc Curve ◽

Diagnostic Odds Ratio ◽

Icu Mortality ◽

Icu Admission ◽

Assessment Scores ◽

Failure Assessment

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 MSOFA 3 in cut-off point of 9.3 were 97.4% and 93.1%, respectively. There was a significant positive correlation between the MSOFA 1 and the SOFA 1 (r: 0.942), 24 hours (r: 0.972), and 48 hours (r: 0.960). Conclusion. The proposed MSOFA and the SOFA scores had high diagnostic accuracy, sensitivity, and specificity for predicting mortality.

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Time for a prehospital-modified sequential organ failure assessment score: An ambulance–Based cohort study

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2021.06.042 ◽

2021 ◽

Author(s):

Francisco Martín-Rodríguez ◽

Ancor Sanz-García ◽

Carlos del Pozo Vegas ◽

Guillermo J. Ortega ◽

Miguel A. Castro Villamor ◽

...

Keyword(s):

Cohort Study ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Assessment Score ◽

Failure Assessment

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The association between the quick sequential organ failure assessment score prior to emergency ICU admission and outcomes in adults with suspected infection

Southern African Journal of Anaesthesia and Analgesia ◽

10.36303/sajaa.2020.26.3.2330 ◽

2020 ◽

pp. 149-154

Author(s):

S Pillay ◽

T Kisten ◽

HM Cassimjee

Keyword(s):

Hospital Mortality ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Icu Mortality ◽

Suspected Infection ◽

Icu Admission ◽

Icu Stay ◽

Failure Assessment ◽

Qsofa Score ◽

Length Of Icu Stay

Background: Sepsis and septic shock are leading causes of mortality world-wide. In patients outside the intensive care unit (ICU) a rising qSOFA (quick Sequential Organ Failure Assessment) score correlates with mortality risk. We sought to investigate if the duration of a qSOFA score ≥ 2 prior to ICU admission further affects outcomes, namely: ICU mortality, in-hospital mortality and length of ICU stay. Method: A retrospective chart review was performed using the electronic ICU database at a quaternary level hospital in Durban, KwaZulu-Natal, examining entries from 1 January 2008 to 31 December 2017. The review included 235 emergency in-hospital adult admissions with suspected infection, of which 144 had a qSOFA score ≥ 2 prior to ICU admission. Results: There was no significant association between the duration of a qSOFA score ≥ 2 prior to ICU admission and ICU mortality (p = 0.975), in-hospital mortality (p = 0.918) and length of ICU stay until demise (p = 0.848) or discharge (p = 0.624). The qSOFA score was significantly associated with ICU mortality with scores of 0, 1, 2 and 3 resulting in ICU mortality rates of 0%, 22.5%, 53.7% and 84.6% respectively (p < 0.001). Conclusion: The duration of a qSOFA score ≥ 2 prior to emergency ICU admission was not significantly associated with ICU mortality, in-hospital mortality or length of ICU stay in adults with suspected infection.

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A Prospective Cohort Study of the Quick Sequential Organ Failure Assessment (qSOFA) Score versus Systemic Inflammatory Response Syndrome (SIRS) Criteria in the Determination and Prognostication of Sepsis in a Philippine Tertiary Hospital

Acta Medica Philippina ◽

10.47895/amp.vi0.3103 ◽

2021 ◽

Keyword(s):

Cohort Study ◽

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Prospective Cohort ◽

Tertiary Hospital ◽

Failure Assessment ◽

Qsofa Score ◽

Sirs Criteria

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Sequential Organ Failure Assessment (SOFA) to Predict Pressure Ulcer Risk in Intensive Care Patients: A Retrospective Cohort Study

Wound Management & Prevention ◽

10.25270/owm.2018.10.3238 ◽

2018 ◽

Vol 64 (10) ◽

pp. 32-38

Author(s):

Maarit Athiala ◽

Esa Soppi ◽

Teijo Saari

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Pressure Ulcer ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Intensive Care Patients ◽

Failure Assessment

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Sequential Organ Failure Assessment Score for Prediction of Mortality of Patients With Rhabdomyolysis Following Exertional Heatstroke: A Longitudinal Cohort Study in Southern China

Frontiers in Medicine ◽

10.3389/fmed.2021.724319 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ming Wu ◽

Conglin Wang ◽

Zheying Liu ◽

Zhifeng Liu

Keyword(s):

Cohort Study ◽

Sequential Organ Failure Assessment ◽

Organ Failure ◽

Sofa Score ◽

Southern China ◽

Heat Stroke ◽

Organ Injury ◽

Medical Emergency ◽

Prediction Of Mortality ◽

Failure Assessment

Background: Heatstroke is a medical emergency that causes multi-organ injury and death without intervention, but limited data are available on the illness scores in predicting the outcomes of exertional heat stroke (EHS) with rhabdomyolysis (RM). The aim of our study was to investigate the Sequential Organ Failure Assessment (SOFA) score in predicting mortality of patients with RM after EHS.Methods: A retrospective cohort study was performed, which included all patients with EHS admitted into the intensive care unit (ICU) of General Hospital of Southern Theater Command of Peoples Liberation Army from January 2008 to June 2019. RM was defined as creatine kinase (CK) > 1,000 U/L. Data, including the baseline data at admission, vital organ function indicators, and 90-day mortality, were reviewed.Results: A total of 176 patients were enrolled; among them, 85 (48.3%) had RM. Patients with RM had a significantly higher SOFA score (4.0 vs. 3.0, p = 0.021), higher occurrence rates of disseminated intravascular coagulation (DIC) (53.1 vs. 18.3%, p < 0.001) and acute liver injury (ALI) (21.4 vs. 5.5%, p = 0.002) than patients with non-RM. RM was positively correlated with ALI and DIC, and the correlation coefficients were 0.236 and 0.365, respectively (both p-values <0.01). Multivariate logistics analysis showed that the SOFA score [odds ratio (OR) 1.7, 95% CI 1.1–2.6, p = 0.024] was the risk factor for 90-day mortality in patients with RM after EHS, with the area under the curve (AUC) 0.958 (95% CI 0.908–1.000, p < 0.001) and the optimal cutoff 7.5 points.Conclusions: Patients with RM after EHS have severe clinical conditions, which are often accompanied by DIC or ALI. The SOFA score could predict the prognosis of patients with RM with EHS. Early treatment strategies based on decreasing the SOFA score at admission may be pivotal to reduce the 90-day mortality of patients with EHS.

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