Utility of SOFA and APACHE II score in sepsis in rural set up MICU

To assess morbidity and mortality as well as to prognosticate the patients by using SOFA and APACHE II scores of patients with sepsis, severe sepsis and multi-organ dysfunction syndrome (MODS) in rural setup ICU.

We carried out prospective study on patients with sepsis as per ACCP guidelines and analysed their clinical and microbiological profile. We calculated SOFA score on day 1, 3 and 7. APACHE II score was also calculated on day of admission. We used both the scores for predicting the outcome.

The mortality rate was 48% in our study group which had alarming proportion of MODS patients (78%). The most common organ involved was lung and the most common organism causing sepsis was Klebseilla. On day 3, the mortality rate of patients with SOFA score less than nine was 9.1%, while the mortality rate of patients with score more than nine was 78%. The trend of mean SOFA score was progressively declining in survivor group. The mean APACHE II score was marginally higher in non-survivor group compared to survivor group, however the difference was not statistically significant.

Serial measurement of SOFA score during first week is very useful tool in predicting the outcome. The APACHE II score on day of admission was not reliable in predicting the mortality rate in this study and we believe that it may need modification in set up like ours.