SOFA Score prognostic performance among patients admitted to High-Dependency Units

Area of Science:

• Critical Care Medicine
• Emergency Medicine
• Clinical Epidemiology

Background:

• Assessing patient prognosis is crucial in Emergency-Department High-Dependency Units (ED-HDU).
• This study evaluated prognostic stratification tools in two Italian ED-HDUs.

Purpose of the Study:

• To assess the prognostic value of the SOFA Score and Charlson Index in Italian ED-HDU patients.
• To determine the ability of these scores to predict mortality and ICU transfer.

Main Methods:

• A prospective study recorded 3311 patients admitted to two Italian ED-HDUs from June 2014 to July 2016.
• Charlson Index and SOFA Score were calculated for comorbidity and organ dysfunction assessment.
• Outcomes included HDU mortality, in-hospital mortality, and ICU transfer.

Main Results:

• HDU mortality was 5% (171 patients). Non-survivors had significantly higher SOFA Scores and more organ dysfunctions.
• Mortality risk increased substantially with higher SOFA Score quartiles, particularly the fourth quartile (14%).
• Higher SOFA Scores were associated with increased HDU mortality (RR 1.55) and ICU transfer, independent of age and Charlson Index.

Conclusions:

• The SOFA Score demonstrates strong predictive capability for mortality in ED-HDU settings.
• SOFA Score effectively identifies patients requiring escalation of care to an Intensive Care Unit.
• Prognostic stratification using SOFA Score aids clinical decision-making in high-dependency units.