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A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
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Related Experiment Video

Updated: Aug 31, 2025

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Modified cardiovascular SOFA score in sepsis: development and internal and external validation.

Hui Jai Lee1, Byuk Sung Ko2, Seung Mok Ryoo3

  • 1Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.

BMC Medicine
|August 21, 2022
PubMed
Summary

A new modified cardiovascular Sequential Organ-Failure Assessment (CV SOFA) score, incorporating vasopressors and lactate, shows improved accuracy in predicting mortality for sepsis patients. This enhanced sepsis prediction tool offers better risk stratification than the original SOFA score.

Keywords:
MortalityOrgan dysfunction scoresSepsisSeverity of illness index

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Area of Science:

  • Critical Care Medicine
  • Clinical Scoring Systems
  • Sepsis Pathophysiology

Background:

  • The Sepsis-3 criteria utilize the Sequential Organ-Failure Assessment (SOFA) score for sepsis definition.
  • Current cardiovascular SOFA (CV SOFA) scoring requires updates due to evolving guideline-recommended vasopressor use.
  • There is a need for a modified CV SOFA score that reflects current clinical practice.

Purpose of the Study:

  • To develop and validate a modified CV SOFA score.
  • To improve the accuracy of sepsis prediction and risk stratification.
  • To incorporate recent vasopressor recommendations and lactate levels into the CV SOFA score.

Main Methods:

  • Development and validation of the modified CV SOFA score using suspected infection, sepsis, and septic shock cohorts.
  • Inclusion of vasopressor use (norepinephrine) and lactate levels in the modified score.
  • Evaluation of predictive validity using Area Under the Receiver Operating Characteristics Curve (AUC) and calibration curves.
  • Comparison of the modified CV SOFA score against the original CV SOFA score for 28-day mortality prediction.

Main Results:

  • The modified CV SOFA score demonstrated significantly higher predictive validity than the original CV SOFA score across development, test, and validation cohorts (AUCs ranging from 0.648 to 0.716).
  • The model incorporating both vasopressors and lactate showed superior performance compared to vasopressor-only models.
  • Calibration was modest, but the modified score identified a greater proportion of patients at risk of septic mortality.

Conclusions:

  • The newly developed modified CV/total SOFA score exhibits superior predictive validity for 28-day mortality in emergency department patients with suspected infection, sepsis, and septic shock.
  • This modified score enhances the identification of patients at high risk for septic mortality.
  • The updated scoring system better reflects current clinical management of sepsis.