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Comparative Prognostic Performance of SOFA2.0 and SOFA for 28-Day Mortality in Patients Developing Sepsis During ECMO
Jia-Yi Chen1,2, Xiao-Ling Gu3, Hai-Yan Liu4
1Intensive Care Unit, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, 310000, People's Republic of China.
Journal of Inflammation Research
|July 14, 2026
Summary
The updated SOFA2.0 score showed similar prognostic performance to the traditional SOFA score in sepsis patients on ECMO. While SOFA2.0 had numerically better discrimination, it was not independently associated with mortality in this study.
Area of Science:
- Critical Care Medicine
- Cardiopulmonary Support
- Sepsis Pathophysiology
Background:
- The Sequential Organ Failure Assessment (SOFA) score is a standard tool for assessing organ dysfunction in sepsis.
- Its accuracy may be compromised in patients on extracorporeal membrane oxygenation (ECMO) due to altered physiological parameters.
- SOFA2.0 is an updated score proposed to improve organ dysfunction assessment in modern critical care.
Purpose of the Study:
- To compare the prognostic performance of SOFA2.0 versus the traditional SOFA score.
- To evaluate their effectiveness in predicting 28-day mortality in sepsis patients undergoing ECMO.
- To assess SOFA2.0's utility in a complex critical care setting.
Main Methods:
- A single-center retrospective cohort study of adult sepsis patients on ECMO.
- SOFA and SOFA2.0 scores were calculated at Sepsis-3 diagnosis.
- Prognostic performance assessed using ROC analysis, logistic regression, NRI, and IDI.
Main Results:
- Fifty-three patients were included; 28-day mortality was 67.9%.
- Both scores were higher in non-survivors. SOFA2.0 had a numerically higher AUC (0.765) than SOFA (0.719), with overlapping confidence intervals.
- SOFA2.0 showed favorable, though not statistically significant, reclassification metrics (NRI=0.728, IDI=0.071).
Conclusions:
- SOFA2.0 demonstrated comparable discriminatory performance to traditional SOFA in sepsis patients on ECMO.
- No clear superiority of SOFA2.0 was established.
- Findings require cautious interpretation due to small sample size and single-center design, necessitating further validation.
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