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The sequential organ failure assessment score predicts 30-day mortality in a geriatric acute care setting

Paolo Mazzola1, Giuseppe Bellelli, Sabrina Perego

  • 1Department of Health Sciences, University of Milano-Bicocca, Milan, Italy. giuseppe.bellelli@unimib.it.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|April 13, 2013
PubMed
Abstract

Insights

The Sequential Organ Failure Assessment (SOFA) score effectively predicts 30-day mortality in elderly patients admitted to geriatric wards. A SOFA score over 4 at 48 hours significantly increases mortality risk, offering a valuable prognostic tool.

Area of Science:

  • Geriatric Medicine
  • Clinical Prognosis
  • Medical Informatics

Background:

  • Existing patient survival prediction tools are often time-consuming and difficult to apply in general medical settings.
  • The Sequential Organ Failure Assessment (SOFA) score is validated for intensive care units but not yet for acute geriatric wards.
  • Predicting short-term mortality in elderly patients admitted to geriatric wards is crucial for effective care management.

Purpose of the Study:

  • To evaluate the predictive capability of the SOFA score for 30-day mortality in elderly patients admitted to an acute geriatric ward.
  • To determine if the SOFA score, commonly used in ICUs, can be reliably applied in a geriatric setting.
  • To identify key predictors of short-term mortality in this specific patient population.

Main Methods:

  • A prospective observational cohort study involving 314 elderly patients admitted to a geriatric clinic from the emergency department.
  • Collection of demographic, functional, and clinical variables upon admission and at 48 hours.
  • Measurement of the SOFA score at admission (SOFA-admission) and 48 hours later (SOFA-48h), with vital status tracked for 30 days post-discharge.

Main Results:

  • Patients who died within 30 days were more likely to be male, have comorbidities, be disabled, and be undernourished.
  • Higher SOFA scores at admission and 48 hours were observed in non-survivors compared to survivors.
  • The SOFA-48h score was the strongest predictor of 1-month mortality, with a score >4 significantly increasing mortality risk (OR = 7.030).

Conclusions:

  • The SOFA score demonstrates utility in predicting 1-month mortality among patients in acute geriatric settings.
  • This user-friendly tool, previously established in ICUs, can be effectively applied to geriatric patients for prognosis.
  • The SOFA score provides a valuable and accessible method for assessing short-term mortality risk in elderly patients admitted to geriatric wards.
Keywords:
FrailtyGeriatric assessmentHospital relatedMorbidityMultimorbiditiesOutcomes.

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