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Ability of a modified Sequential Organ Failure Assessment score to predict mortality among sepsis patients in a

Bodin Khwannimit1, Rungsun Bhurayanontachai1, Veerapong Vattanavanit1

  • 1Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.

Acute and Critical Care
|August 17, 2022
PubMed
Abstract

Insights

The modified Sequential Organ Failure Assessment (mSOFA) score accurately predicts mortality in sepsis patients, offering a valuable alternative to the original SOFA score, especially in resource-limited settings. This sepsis mortality prediction tool demonstrates improved accuracy.

Area of Science:

  • Critical Care Medicine
  • Sepsis Pathophysiology
  • Clinical Scoring Systems

Background:

  • The original Sequential Organ Failure Assessment (SOFA) score has limitations in routine sepsis monitoring, particularly in resource-constrained environments.
  • Certain SOFA variables are not consistently measured, impacting its utility for timely sepsis assessment.

Purpose of the Study:

  • To evaluate the accuracy of the modified SOFA (mSOFA) score in predicting mortality in sepsis patients.
  • To compare the predictive performance of the mSOFA score against the original SOFA score.

Main Methods:

  • Retrospective analysis of 1,522 sepsis patients admitted to a medical intensive care unit (2011-2018).
  • Primary outcome: all-cause in-hospital mortality.
  • Comparison of SOFA and mSOFA scores using receiver operating characteristic (ROC) curves.

Main Results:

  • The mSOFA score demonstrated significantly higher discrimination for all-cause in-hospital mortality (AUC 0.891 vs. 0.879), ICU mortality (AUC 0.880 vs. 0.871), and 28-day mortality (AUC 0.887 vs. 0.874).
  • mSOFA's predictive ability for in-hospital and 28-day mortality was superior across subgroups based on age, sepsis severity, and lactate levels.
  • mSOFA showed comparable performance to SOFA in predicting mortality for patients with cirrhosis or hepatic dysfunction.

Conclusions:

  • The modified SOFA (mSOFA) score serves as a reliable alternative to the original SOFA score for predicting mortality in ICU-admitted sepsis patients.
  • mSOFA offers a practical and accurate tool for sepsis outcome prediction, particularly where SOFA components are not routinely available.
Keywords:
intensive care unitorgan failuresepsisshock

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