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A comparison of three organ dysfunction scores: MODS, SOFA and LOD for predicting ICU mortality in critically ill
1Division of Critical Care, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. kbordin@medicine.psu.ac.th
Objective:
To compare the validity of the Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), and Logistic Organ Dysfunction Score (LOD) for predicting ICU mortality of Thai critically ill patients.
Material And Method:
A retrospective study was made of prospective data collected between the 1st July 2004 and 31st March 2006 at Songklanagarind Hospital.
Results:
One thousand seven hundred and eighty two patients were enrolled in the present study. Two hundred and ninety three (16.4%) deaths were recorded in the ICU. The areas under the Receiver Operating Curves (A UC) for the prediction of ICU mortality the results were 0.861 for MODS, 0.879 for SOFA and 0.880 for LOD. The AUC of SOFA and LOD showed a statistical significance higher than the MODS score (p = 0.014 and p = 0.042, respectively). Of all the models, the neurological failure score showed the best correlation with ICU mortality.
Conclusion:
All three organ dysfunction scores satisfactorily predicted ICU mortality. The LOD and neurological failure had the best correlation with ICU outcome.
Insights
The Logistic Organ Dysfunction Score (LOD) and Sequential Organ Failure Assessment (SOFA) scores effectively predict ICU mortality in Thai patients, outperforming the Multiple Organ Dysfunction Score (MODS). Neurological failure specifically showed the strongest correlation with patient outcomes.
Area of Science:
- Critical Care Medicine
- Prognostic Biomarkers
- Intensive Care Unit (ICU) Outcomes
Background:
- Accurate prediction of ICU mortality is crucial for patient management.
- Several organ dysfunction scores exist, but their comparative validity in specific populations requires investigation.
- The Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), and Logistic Organ Dysfunction Score (LOD) are commonly used.
Purpose of the Study:
- To evaluate and compare the predictive accuracy of MODS, SOFA, and LOD for ICU mortality.
- To identify the most reliable scoring system for critically ill Thai patients.
- To assess the contribution of neurological failure to predicting ICU outcomes.
Main Methods:
- Retrospective analysis of prospective data from 1,782 critically ill patients.
- Data collected between July 2004 and March 2006 at Songklanagarind Hospital.
- Comparison of Area Under the Receiver Operating Curves (AUC) for MODS, SOFA, and LOD in predicting ICU mortality.
Main Results:
- Overall ICU mortality rate was 16.4% (293 deaths).
- SOFA (AUC 0.879) and LOD (AUC 0.880) demonstrated significantly higher predictive accuracy than MODS (AUC 0.861).
- Neurological failure component showed the strongest correlation with ICU mortality across all models.
Conclusions:
- MODS, SOFA, and LOD are all satisfactory predictors of ICU mortality.
- LOD and the neurological failure score exhibit the best correlation with ICU outcomes in this Thai cohort.
- Findings support the use of LOD and neurological assessment for prognostication in critically ill patients.