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Application of the Sequential Organ Failure Assessment score for predicting mortality in patients with acute
Shao-Sung Huang1, Ying-Hwa Chen, Tse-Min Lu
1Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Insights
The Sequential Organ Failure Assessment (SOFA) score accurately predicts mortality in acute myocardial infarction (AMI) patients, outperforming the Thrombolysis in Myocardial Infarction (TIMI) score for long-term outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Medical Prognostics
Background:
- Established risk scores like TIMI and GRACE predict mortality in acute myocardial infarction (AMI).
- The prognostic utility of the Sequential Organ Failure Assessment (SOFA) score in AMI patients requires further investigation.
- Comparative analysis of SOFA, TIMI, and GRACE scores for predicting AMI mortality is needed.
Purpose of the Study:
- To assess the accuracy of the SOFA score in predicting mortality among AMI patients.
- To compare the discriminatory performance of the SOFA score against established TIMI and GRACE risk scores.
- To evaluate the prognostic value of the SOFA score for both short-term and long-term mortality in AMI.
Main Methods:
- Retrospective analysis of 726 consecutive AMI patients.
- Calculation of Thrombolysis in Myocardial Infarction (TIMI) Risk Score, Global Registry of Acute Coronary Events (GRACE) Score, and Sequential Organ Failure Assessment (SOFA) score.
- All-cause mortality as the study endpoint, with follow-up for at least 3 years or until death. Area Under the Curve (AUC) analysis for predictive ability.
Main Results:
- SOFA score demonstrated higher accuracy (AUC 0.79) for in-hospital mortality compared to GRACE (AUC 0.73) and TIMI (AUC 0.67) scores.
- Both SOFA and GRACE scores significantly outperformed TIMI score in predicting 1-year and 3-year mortality.
- Multivariate Cox regression confirmed SOFA score as an independent predictor of long-term mortality in AMI patients (HR 1.313).
Conclusions:
- The SOFA score offers valuable prognostic information for patients with AMI.
- SOFA and GRACE scores provide superior discrimination for long-term mortality in AMI compared to the TIMI score.
- SOFA score is a significant independent predictor of long-term mortality in the AMI population.
Background:
Thrombolysis in Myocardial Infarction (TIMI) score and Global Registry of Acute Coronary Events (GRACE) score have been validated as predictors of death in patients with acute myocardial infarction (AMI). This study was undertaken to determine whether the Sequential Organ Failure Assessment (SOFA) score had good accuracy for predicting mortality in AMI patients, and to compare the discriminatory performance of the 3 risk scores (RSs).
Methods:
This was a retrospective study. We calculated the TIMI RS, GRACE RS, and SOFA score for 726 consecutive AMI patients. The study endpoint was all-cause mortality. All patients were followed up for at least 3 years or until the occurrence of death. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive ability of each score at different time points.
Results:
For in-hospital death, the AUC were 0.67 for TIMI RS, 0.73 for GRACE RS, and 0.79 for SOFA score (P<0.001, respectively). However, the SOFA score and GRACE RS were significantly better for predicting the 1-year (P<0.001, respectively) and 3-year (P<0.001, respectively) mortality than the TIMI RS was. Multivariate Cox regression analysis revealed that the SOFA score was an independent predictor of long-term mortality in AMI patients [hazard ratio (HR), 1.313; 95% CI, 1.191-1.447].
Conclusions:
The SOFA score provides potentially valuable prognostic information on clinical outcome when applied to patients with AMI. Compared with TIMI RS, both SOFA score and GRACE RS provide better discrimination for long-term mortality in patients presenting with AMI.