A new SOFA score calculation to improve the predictive performance for mortality in sepsis-associated disseminated...

The change in the sequential organ failure assessment (SOFA) score from the entry day, a delta-SOFA (SOFA_Δ), has been proposed as a better indicator for predicting mortality, and potentially as an endpoint in clinical trials. However, there are some concerns that the value of the absolute SOFA score has not been considered. The purpose of the study is to examine whether the addition of an absolute SOFA score can increase the predictive performance of SOFA_Δ.

Data obtained from 297 patients with sepsis-associated disseminated intravascular coagulopathy (DIC) in multiinstitutional post-marketing surveys were analyzed retrospectively. The SOFA_Comb (SOFA_Δ score + absolute SOFA score) and SOFA_Δ were calculated, and the performance of each indicator was analyzed in terms of predictive ability for 28-day mortality.

The area under the receiver operating curve (AUC) for the mortality of SOFA_Comb on day 2, 4, 7 were significantly greater compared to those of SOFA_Δ (P <0.001, =0.002, <0.001, respectively). In addition, the accuracy [(True positive + True negative) / total number at the best cutoff points] of SOFA_Comb was better than that of SOFA_Δ.

SOFA_Comb is simple to calculate and provides better predictive performance compared to SOFA_Δ for predicting mortality.