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Serial Evaluation of Sequential Organ Failure Assessment Score (SOFA) as a Predictor of Outcome in Children Admitted
1Department of Pediatric Intensive Care Unit, Manipal Hospital, Bengaluru, Karnataka, India.
Insights
The Sequential Organ Failure Assessment (SOFA) score effectively predicts outcomes in pediatric intensive care unit (PICU) patients. Serial SOFA assessments, particularly Delta SOFA, offer valuable prognostic insights for critically ill children.
Area of Science:
- Pediatric critical care medicine
- Clinical scoring systems
- Prognostic indicators
Background:
- The Sequential Organ Failure Assessment (SOFA) score is utilized to quantify organ system dysfunction.
- Evaluating the SOFA score's predictive capability for patient outcomes in the Pediatric Intensive Care Unit (PICU) is crucial.
Background:
Sequential organ failure assessment score (SOFA) is a score to quantify organ system dysfunction. This study was done to evaluate SOFA as a predictor of outcomes in children in pediatric intensive care unit (PICU).
Objective:
(A) To determine whether initial SOFA, Delta SOFA, and SOFA score at 72 hours are better predictors of outcome in terms of sensitivity and specificity. (B) To compare the initial SOFA, Delta SOFA, and SOFA score at 72 hours.
Materials And Methods:
A prospective observational study was conducted on 160 patients aged from 29 days to 12 years admitted in PICU of a Tertiary Care Hospital in a metropolitan city in India for a period of 1 year. Then, the initial SOFA score, 72-hour SOFA, and Delta SOFA (T0 SOFA - T72 SOFA) were calculated and patients were followed up till discharge from PICU or deceased.
Results:
The best threshold to differentiate between discharged and deceased corresponds to as initial SOFA of 7.50 with a sensitivity of 64.71%, and specificity of 89.51%. The similar threshold for 72 hours SOFA is 10.50 which correspond to a sensitivity of 76.47% and specificity of 96.50%. The study showed strong evidence (p-value < 0.05) that, patients whose Delta SOFA values increased from the previous value (-1.5), had a greater chance to succumb to illness. Delta SOFA had the best sensitivity (82.35%) and 72-hour SOFA had the best specificity (96.50%) in predicting the outcome of PICU patients.
Conclusion:
This study emphasizes the use of SOFA score as a prognostic indicator in critically ill children, as variables measured are easily available.
How To Cite This Article:
Lois A, Save S. Serial Evaluation of Sequential Organ Failure Assessment Score (SOFA) as a Predictor of Outcome in Children Admitted in Pediatric Intensive Care Unit (PICU) at Tertiary Care Hospital. Indian J Crit Care Med 2023;27(8):590-595.
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