The prognostic implication of the SOFA score on acutely admitted medical patients

Area of Science:

• Critical Care Medicine
• Prognostic Biomarkers
• Medical Informatics

Background:

• The Sequential Organ Failure Assessment (SOFA) score is widely used in intensive care units.
• Its prognostic value in general medical admissions requires further investigation.
• Accurate prediction of mortality and ICU admission is crucial for patient management.

Purpose of the Study:

• To evaluate the prognostic implication of the SOFA score in all acutely admitted medical patients.
• To assess the SOFA score's predictive accuracy for 30-day mortality.
• To determine the SOFA score's ability to predict intensive care unit (ICU) admission.

Main Methods:

• Area Under the Receiver Operating Characteristic curve (AUROC) was used to calculate discriminatory power.
• Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test.
• The study analyzed data from acutely admitted medical patients.

Main Results:

• The SOFA score demonstrated an AUROC of 0.68 for 30-day mortality (95% CI, 0.64 to 0.71).
• The AUROC for ICU admission was 0.71 (95% CI, 0.66 to 0.76).
• Goodness-of-fit indicated acceptable calibration for both outcomes.

Conclusions:

• The SOFA score exhibits average predictive ability for 30-day mortality and ICU admission in this patient cohort.
• Calibration of the SOFA score was found to be acceptable.
• Substituting the Glasgow Coma Scale (GCS) with the Alert, Voice, Pain, Unresponsive (AVPU) scale resulted in unacceptable SOFA score performance.