Feasibility of the modified sequential organ function assessment score in a resource-constrained setting: a...

Area of Science:

• Critical Care Medicine
• Global Health
• Health Systems Research

Background:

• Sub-Saharan Africa faces a significant burden of critical illness.
• Limited healthcare resources in the region pose challenges for patient management.
• The Sequential Organ Function Assessment (SOFA) score is a tool used to assess organ dysfunction.

Purpose of the Study:

• To evaluate the feasibility and utility of a modified SOFA (mSOFA) score.
• To assess morbidity and mortality in an intensive care unit (ICU) in a resource-limited setting.
• To adapt the SOFA score for use with pulse oximetry in areas with limited access to arterial blood gas analysis.

Main Methods:

• A prospective, observational cohort study was conducted in the ICU of Mulago Hospital, Kampala, Uganda.
• 118 patients over 12 years of age were enrolled.
• The SOFA score was modified by replacing the PaO2/FiO2 ratio with SpO2/FiO2, termed the mSOFA score, and assessed at admission and 48 hours.

Main Results:

• The ICU cohort had a high mortality rate of 46.6%.
• Non-survivors exhibited significantly higher initial, mean, and highest mSOFA scores compared to survivors.
• An increase in mSOFA score after 48 hours was also significantly higher in non-survivors.
• Receiver operating characteristic (ROC) curve analysis showed moderate predictive ability for mSOFA scores (AUCs ranging from 0.68 to 0.76).

Conclusions:

• The calculation of the mSOFA score is feasible within an ICU population in a resource-limited country.
• The study highlights the potential utility of the mSOFA score in this setting.
• Additional research is required to definitively establish the association between mSOFA scores and patient mortality.