Postoperative organ dysfunction assessed using simplified eSOFA is associated with mortality: a single-center...

Area of Science:

• Anesthesiology and Perioperative Medicine
• Critical Care Medicine
• Surgical Outcomes Research

Background:

• Postoperative organ dysfunction is a significant concern following noncardiac surgery.
• Accurate assessment of organ dysfunction is crucial for predicting patient mortality.
• Existing scoring systems may have limitations in certain surgical populations.

Purpose of the Study:

• To investigate the association between postoperative organ dysfunction, assessed by the simplified eSOFA score, and 90-day mortality.
• To evaluate the utility of eSOFA in predicting mortality after noncardiac surgery.
• To compare the predictive performance of eSOFA with established scores like SOFA and APACHE II.

Main Methods:

• Retrospective analysis of 24,558 adult patients undergoing noncardiac surgery (2009-2019).
• Primary exposure: postoperative organ dysfunction using eSOFA within 2 days (positive eSOFA).
• Primary outcome: 90-day mortality, analyzed using multivariable Cox regression and C-statistics for predictive performance in ICU patients.

Main Results:

• 7.5% of patients experienced positive eSOFA, with a 0.9% 90-day mortality rate.
• Positive eSOFA was independently associated with a 3-fold increased risk of 90-day mortality (aHR: 3.03).
• Increasing numbers of eSOFA-positive items correlated with higher mortality risk; predictive performance comparable to SOFA and APACHE II in ICU patients.

Conclusions:

• Postoperative organ dysfunction identified by eSOFA within 2 days is an independent predictor of 90-day mortality in noncardiac surgery.
• The eSOFA score offers a valuable and simplified method for assessing risk in these patients.
• Further research may explore the integration of eSOFA into routine clinical practice for enhanced patient monitoring.