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The predictive value of SOFA and APSIII scores for 28-day mortality risk in SIMI: a cohort study based on the

Chang Liu1, Hao Wang1, Chenyang Liu1

  • 1Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Frontiers in Cellular and Infection Microbiology
|August 13, 2025
PubMed
Abstract

Insights

The Sequential Organ Failure Assessment (SOFA) and Acute Physiology Score III (APSIII) effectively predict mortality in sepsis-induced myocardial injury (SIMI). These scores aid in identifying high-risk patients for timely clinical intervention.

Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Prognostic Biomarkers

Background:

  • Sepsis-induced myocardial injury (SIMI) is a critical complication of sepsis.
  • Accurate prognostic scoring systems are essential for managing SIMI patients.

Purpose of the Study:

  • To systematically identify and evaluate scoring systems for predicting prognosis in patients with SIMI.
  • To assess the performance of various scoring systems in predicting 28-day mortality.

Main Methods:

  • Data were extracted from the MIMIC-IV database.
  • Logistic and Cox regression analyses identified risk factors for 28-day mortality.
  • Prognostic performance was evaluated using ROC curves, Kaplan-Meier survival, and decision curve analysis (DCA).

Main Results:

  • Sequential Organ Failure Assessment (SOFA) and Acute Physiology Score III (APSIII) were identified as independent risk factors for 28-day mortality in SIMI patients.
  • SOFA (AUC=0.685) and APSIII (AUC=0.683) demonstrated superior predictive performance compared to other scoring systems.
  • DCA confirmed that SOFA and APSIII provided better net benefit for risk stratification.

Conclusions:

  • SOFA and APSIII scores are effective tools for identifying high-risk patients with SIMI.
  • These validated scoring systems offer evidence-based support for early clinical interventions in SIMI management.
Keywords:
APSIII scoreMIMIC-IV databaseSOFA scoremortality risksepsissepsis-induced myocardial injury (SIMI)

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