scholarly journals Sequential Organ Failure Assessment (SOFA) score in predicting morbidity and mortality in community and hospital acquired acute renal failure patient requiring dialysis

2018 ◽  
Vol 5 (3) ◽  
pp. 727
Author(s):  
Amit Pambhar ◽  
G. K. Mukhiya
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
P Value ◽  
Renal Failure Patient ◽  
Failure Assessment ◽  
Hospital Acquired ◽  
Excellent Tool

Background: The Sequential Organ Failure Assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study was planned to compare outcome and organ failure status of community (CAARF) and hospital acquired acute renal failure (HAARF) patients requiring dialysis using SOFA score.Methods: The present prospective observational study was conducted on fifty consecutive acute renal failure patients age more than 18 years of either sex requiring dialysis. Patients who developed ARF after 24 hours of admission were referred as HAARF and patients who had acute renal failure on admission were considered as CAARF. The Sequential Organ Failure Assessment (SOFA) score was used to track a patient's status during the stay in an intensive care unit in both HAARF and CAARF patients.Results: Out of 50 patients, 31(62%) patients had community acquired renal failure and 19 (38%) patients had hospital acquired renal failure. Mean SOFA in HAARF patients was high (8.84±3.13) compare to CAARF patients (6.16± 2.80). The p value calculated was 0.003 which was significant. High SOFA Score (>11) were seen predominantly in HAARF (83.3%) patients compare to CAARF (16.7%), followed by 57.1% of patients in HAARF and 42.9% of patients in CAARF had SOFA score between 9 to11.Conclusions: High SOFA Score were seen predominantly in HAARF patients compare to CAARF and so poor outcome compare to CAARF. So, SOFA score may be used in explaining prognosis and outcome of ARF patients.

scholarly journals Predictors of maternal outcome in women on mechanical ventilation in an obstetric intensive care unit: an observational study

2019 ◽  
Vol 8 (2) ◽  
pp. 721
Author(s):  
Tanu Soni ◽  
Priyadarshini Tiwari
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Observational Study ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Coagulation System ◽  
P Value ◽  
Failure Assessment

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.

scholarly journals Association of Sequential Organ Failure Assessment (SOFA) components with mortality

2021 ◽  
Author(s):  
Anssi Pölkki ◽  
Pirkka T Pekkarinen ◽  
Jukka Takala ◽  
Tuomas Selander ◽  
Matti Reinikainen
Keyword(s):  
Renal Failure ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Hepatic Failure ◽  
Hospital Death ◽  
Cardiovascular Failure ◽  
Failure Assessment

Abstract BackgroundSequential Organ Failure Assessment (SOFA) is a practical and widely used method to describe and quantify the presence and severity of organ system dysfunctions and failures. Some proposals suggest that SOFA could be employed as an endpoint in interventional trials. To justify this, all SOFA components should have comparable weights as organ dysfunction measures. In this study we aimed to investigate whether the associations of different SOFA components with in-hospital mortality are comparable.MethodsWe performed a study based on nationwide register data on adult patients admitted to 26 Finnish intensive care units (ICUs) during 2012−2015. We determined the SOFA score as the maximum score in the first 24 hours after ICU admission. We defined organ failure as an organ-specific SOFA score of three or higher. We evaluated the association of different SOFA component scores with mortality using multivariable logistic regression analysis. ResultsOur study population comprised 63,756 ICU patients. Overall hospital mortality was 10.7%. In-hospital mortality was 22.5% for patients with respiratory failure, 34.8% for those with coagulation failure, 40.1% for those with hepatic failure, 14.9% for those with cardiovascular failure, 26.9% for those with neurologic failure and 34.6% for the patients with renal failure. The age-adjusted odds ratio for in-hospital death was 2.41 [95% confidence interval (CI) 2.27-2.56] for respiratory failure, 4.04 (95% CI 3.57-4.57) for coagulation failure, 4.24 (95% CI 3.47-5.17), for hepatic failure, 1.57 (95% CI 1.47-1.67) for cardiovascular failure, 5.00 (95% CI 4.71-5.30) for neurologic failure, and 4.93 (95% CI 4.58-5.32) for renal failure. Organ failure combinations including cardiovascular failure were associated with lower mortality than other organ failure combinations.ConclusionsAll SOFA components are associated with mortality, but their weights are not comparable. High cardiovascular SOFA scores do not imply an equally high risk as high scores of other components.

Does mid-regional pro-adrenomedullin (MR-proADM) improve the sequential organ failure assessment-score (SOFA score) for mortality-prediction in patients with acute infections? Results of a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ellen Haag ◽  
Claudia Gregoriano ◽  
Alexandra Molitor ◽  
Milena Kloter ◽  
Alexander Kutz ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Predictive Value ◽  
Acute Infection ◽  
Mortality Prediction ◽  
P Value ◽  
Assessment Score ◽  
Failure Assessment

Abstract Objectives Risk stratification in patients with infection is usually based on the Sequential Organ Failure Assessment-Score (SOFA score). Our aim was to investigate whether the vasoactive peptide mid-regional pro-adrenomedullin (MR-proADM) improves the predictive value of the SOFA score for 30-day mortality in patients with acute infection presenting to the emergency department (ED). Methods This secondary analysis of the prospective observational TRIAGE study included 657 patients with infection. The SOFA score, MR-proADM, and traditional inflammation markers were all measured at time of admission. Associations of admission parameters and 30-day mortality were investigated by measures of logistic regression, discrimination analyses, net reclassification index (NRI), and integrated discrimination index (IDI). Results MR-proADM values were higher in non-survivors compared with survivors (4.5 ± 3.5 nmol/L vs. 1.7 ± 1.8 nmol/L) with an adjusted odds ratio of 26.6 (95% CI 3.92 to 180.61, p=0.001) per 1 nmol/L increase in admission MR-proADM levels and an area under the receiver operator curve (AUC) of 0.86. While the SOFA score alone revealed an AUC of 0.81, adding MR-proADM further improved discrimination (AUC 0.87) and classification within predefined risk categories (NRI 0.075, p-value <0.05). An admission MR-proADM threshold of 1.75 nmol/L provided the best prognostic accuracy for 30-day mortality; with a sensitivity of 81% and a specificity of 75%, and a negative predictive value of 98%. Conclusions MR-proADM improved the mortality risk stratification in patients with infection presenting to the ED beyond SOFA score alone and may further improve initial therapeutic site-of-care decisions. Trial registration ClinicalTrials.gov NCT01768494. Registered January 15, 2013.

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 ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Cardiovascular Events ◽  
Failure Assessment ◽  
First Time

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.

scholarly journals Early Changes in the Sequential Organ Failure Assessment Score Among Patients With Sepsis-Induced Disseminated Intravascular Coagulation

2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 332S-339S
Author(s):  
Katsunori Mochizuki ◽  
Kotaro Mori ◽  
Yuta Nakamura ◽  
Ryo Uchimido ◽  
Hiroshi Kamijo ◽  
...  
Keyword(s):  
Infection Control ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Disseminated Intravascular Coagulation ◽  
Sofa Score ◽  
Early Improvement ◽  
Initial Infection ◽  
Soluble Thrombomodulin ◽  
Failure Assessment ◽  
Recombinant Human Soluble Thrombomodulin

It is unclear whether initial infection control or anticoagulant therapy exerts a greater effect on early changes in the Sequential Organ Failure Assessment (SOFA) score among patients with sepsis-induced disseminated intravascular coagulation (DIC). This retrospective propensity score cohort study aimed to evaluate whether adequacy of infection control or anticoagulation therapy had a greater effect on early changes in the SOFA scores among 52 patients with sepsis-induced DIC. Inadequate initial infection control was associated with a lower 28-day survival rate among patients with sepsis-induced DIC (odds ratio [OR]: 0.116, 95% confidence interval [CI]: 0.022-0.601; P = .010); however, the adequacy was not associated with an early improvement in the SOFA score. However, despite adjusting for inadequate initial infection control, administration of recombinant human soluble thrombomodulin was associated with an early improvement in the SOFA score (OR: 5.058, 95% CI: 1.047-24.450; P = .044). Therefore, early changes in the SOFA score within 48 hours after the DIC diagnosis were more strongly affected by the administration of recombinant human soluble thrombomodulin than the adequacy of initial infection control.

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