scholarly journals Establishment of a prognostic model based on the Sequential Organ Failure Assessment score for patients with first-time acute myocardial infarction

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110119
Author(s):  
Shuai Zheng ◽  
Jun Lyu ◽  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
...  

Objective This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. Methods We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. Results An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. Conclusion The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.

2010 ◽  
Vol 4 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Colin K. Grissom ◽  
Samuel M. Brown ◽  
Kathryn G. Kuttler ◽  
Jonathan P. Boltax ◽  
Jason Jones ◽  
...  

ABSTRACTObjective: The Sequential Organ Failure Assessment (SOFA) score has been recommended for triage during a mass influx of critically ill patients, but it requires laboratory measurement of 4 parameters, which may be impractical with constrained resources. We hypothesized that a modified SOFA (MSOFA) score that requires only 1 laboratory measurement would predict patient outcome as effectively as the SOFA score.Methods: After a retrospective derivation in a prospective observational study in a 24-bed medical, surgical, and trauma intensive care unit, we determined serial SOFA and MSOFA scores on all patients admitted during the 2008 calendar year and compared the ability to predict mortality and the need for mechanical ventilation.Results: A total of 1770 patients (56% male patients) with a 30-day mortality of 10.5% were included in the study. Day 1 SOFA and MSOFA scores performed equally well at predicting mortality with an area under the receiver operating curve (AUC) of 0.83 (95% confidence interval 0.81-.85) and 0.84 (95% confidence interval 0.82-.85), respectively (P = .33 for comparison). Day 3 SOFA and MSOFA predicted mortality for the 828 patients remaining in the intensive care unit with an AUC of 0.78 and 0.79, respectively. Day 5 scores performed less well at predicting mortality. Day 1 SOFA and MSOFA predicted the need for mechanical ventilation on day 3, with an AUC of 0.83 and 0.82, respectively. Mortality for the highest category of SOFA and MSOFA score (>11 points) was 53% and 58%, respectively.Conclusions: The MSOFA predicts mortality as well as the SOFA and is easier to implement in resource-constrained settings, but using either score as a triage tool would exclude many patients who would otherwise survive.(Disaster Med Public Health Preparedness. 2010;4:277-284)


Author(s):  
Tanu Soni ◽  
Priyadarshini Tiwari

Background: Present study was designed to note the indications for and the complications and outcome of women on mechanical ventilation in our obstetric intensive care unit, and in addition to look for the applicability and correlation of Sequential Organ Failure Assessment (SOFA) scores for the prediction of outcome in these women.Methods: A prospective observational study was conducted in the obstetric intensive care unit of our teaching hospital which included all women requiring mechanical ventilation in the study period. The diagnosis of the woman on admission, the clinical course and outcome along with total maximum sequential organ failure assessment (SOFA) score and SOFA score for each system were noted. Women were divided into two groups, survivors and non-survivors. Student t test and chi square test were used for analysis.Results: The foremost indication for mechanical ventilation was hypertension in pregnancy namely eclampsia and pre-eclampsia, followed by obstetric hemorrhage and then by hepatic failure. Maternal mortality rose significantly as the number of days of mechanical ventilation increased (p value <0.05). The total SOFA score correlated highly significantly with the outcome (p<0.0001).Conclusions: In women with eclampsia and pre-eclampsia suffering from respiratory failure, survival is inversely correlated with the number of days of mechanical ventilation. The total SOFA score is highly predictive of the woman’s outcome and all individual organ system scores also significantly correlate with outcome except for the score of coagulation system.


2021 ◽  
Vol 8 (2) ◽  
pp. 686
Author(s):  
Tushar Nagyan ◽  
Mriganko S. Ray ◽  
Priyanshu M. Varshney ◽  
Sarvpreet S. Malhi ◽  
Naresh A. Modi ◽  
...  

Background: For the last few decades critical care medicine has been reinventing and fine-tuning organ dysfunction grading to establish a survival scoring system to accurately predict survivality and organ salvageability of critically ill patient in intensive care unit (ICU). The sequential organ failure assessment (SOFA) score assesses the performance of several organ systems in the body and assigns a score, where higher the SOFA score, higher the likelihood of mortality and morbidity. Early prediction of outcome in surgical sepsis is very likely to aid suitable modification of management strategies 13. This may improve prognosis in such patients and prevent mortality to some extent.  Methods: Observational and prospective study of 30 cases, aged>18 years & patients admitted to post-operative ward and surgical intensive care unit (SICU) with suspected surgical infection, and with two or more criteria of SIRS. Results: In this study out of total 30 patients 63.3% patients survived and 36.6% succumbed to their illness. Our study depicted significant increase in mortality rate when the SOFA score was above 12. Ventilated patient showed a higher mortality rate. Delta, mean, total SOFA Score were statistically significant in our study.Conclusions: SOFA score is useful in predicting mortality and morbidity in critically ill patients, because has a strong correlation between a rise in the score and mortality in all stages of admission. In our study, out of 09 patients whose T0 SOFA score was very high (above 12) out of which 03 patients only survived.


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