Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective...

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Clinical Scoring Systems

Background:

• The Third International Consensus Definitions for Sepsis and Septic Shock proposed the Sequential Organ Failure Assessment (SOFA) score.
• The utility of the SOFA score in the emergency department (ED) for sepsis management is not well-established.
• Assessing novel scoring systems for sepsis prediction in the ED is crucial for timely intervention.

Purpose of the Study:

• To evaluate the predictive ability of a modified SOFA (mSOFA) score for mortality in patients with probable sepsis in the ED.
• To determine the negative predictive value of the mSOFA score in identifying low-risk sepsis patients.

Main Methods:

• A retrospective study was conducted at an urban tertiary teaching hospital.
• Data from July 2015 to June 2016 included patients with probable sepsis recorded in the ED Information System (EDIS).
• A sample of patients had their clinical records manually reviewed to assign an mSOFA score and assess 30-day mortality.

Main Results:

• Out of 474 probable sepsis patients, 228 were manually reviewed.
• The mSOFA score was a significant predictor of mortality.
• 30-day mortality was 25% for positive mSOFA scores versus 2.1% for negative scores (OR 15.2, P < 0.001), yielding a negative predictive value of 97.9%.

Conclusions:

• The mSOFA score effectively differentiates sepsis patients into high and low mortality risk groups in the ED setting.
• The high negative predictive value of the mSOFA score suggests practical utility for risk stratification.
• Further prospective studies are required to validate these findings for routine ED use.