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Automating and simplifying the SOFA score in critically ill patients with cancer
Joseph L Nates1, Marylou Cárdenas-Turanzas, Chris Wakefield
1Department of Critical Care Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. jlnates@mdanderson.org
Abstract:
The aim was to demonstrate the performance of a modified version of the Sequential Organ Failure Assessment (SOFA) score to predict mortality in medical and surgical patients with cancer. We performed an electronic retrospective review of databases. We included adult patients with cancer admitted into a 53-bed ICU over 28 months. We electronically calculated a modified SOFA (mSOFA) score at admission. A majority of the patients were admitted into the surgical ICU. Of 328 nonsurvivors, 85.1 per cent were medical patients and only 14.9 per cent surgical patients. The mean admission mSOFA scores for medical and surgical patients were 4.7 +/- 3.2 and 1.7 +/- 1.9, respectively. The overall area under the curve (AUC) of the mSOFA score was 0.84. The AUCs for medical and surgical patients were 0.72 and 0.78, respectively. Our results demonstrate that electronic assessment of mSOFA score has potential in resource allocation decisions as well as in critical care outreach programs.
Insights
A modified Sequential Organ Failure Assessment (SOFA) score effectively predicts mortality in cancer patients. This electronic assessment aids critical care decisions and resource allocation in ICUs.
Area of Science:
- Critical Care Medicine
- Oncology
- Health Informatics
Background:
- Predicting mortality in cancer patients admitted to the ICU is crucial for clinical decision-making.
- The Sequential Organ Failure Assessment (SOFA) score is a common tool, but its performance in cancer patients requires further evaluation.
- Cancer patients present unique physiological challenges that may influence the accuracy of standard scoring systems.
Purpose of the Study:
- To evaluate the performance of a modified SOFA (mSOFA) score in predicting mortality among cancer patients in an intensive care unit (ICU).
- To assess the utility of electronically calculated mSOFA scores for resource allocation and critical care outreach.
Main Methods:
- Retrospective electronic database review of adult cancer patients admitted to a 53-bed ICU over 28 months.
- Electronic calculation of a modified SOFA (mSOFA) score upon ICU admission.
- Analysis of mortality rates and comparison of mSOFA scores between medical and surgical patient groups.
Main Results:
- The study included a significant number of non-survivors, with 85.1% being medical patients.
- Mean admission mSOFA scores differed significantly between medical (4.7 ± 3.2) and surgical (1.7 ± 1.9) cancer patients.
- The overall area under the curve (AUC) for the mSOFA score was 0.84, with AUCs of 0.72 for medical and 0.78 for surgical patients.
Conclusions:
- The modified SOFA (mSOFA) score demonstrates good performance in predicting mortality in cancer patients.
- Electronic assessment of mSOFA scores is a feasible and potentially valuable tool for critical care settings.
- Findings suggest the mSOFA score can aid in resource allocation and the development of critical care outreach programs for cancer patients.