Sequential Organ Failure Assessment Score as a Predictor of Intensive Care Unit Mortality in Patients With...

Maxillofacial trauma that requires intensive care may be complicated by systemic organ dysfunction and mortality. The Sequential Organ Failure Assessment (SOFA) score provides an objective measure of physiological deterioration, whereas serial assessments may offer greater prognostic information than a single measurement. This study evaluated the prognostic performance of the admission SOFA score, 48-hour SOFA score, and ΔSOFA score (ΔSOFA) for predicting intensive care unit (ICU) mortality.

This prospective observational study included 130 consecutive patients with maxillofacial trauma admitted to the ICU over a one-year period from June 2018 to May 2019. SOFA scores were recorded at admission to the ICU (SOFA-0) and at 48 hours (SOFA-48). ΔSOFA was calculated as SOFA-48 minus SOFA-0. The patients were categorized according to their ICU survival status. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory ability of each SOFA score.

Of 130 patients, 105 survived, and 25 died during ICU admission. Non-survivors had higher SOFA-0 scores than survivors (11.0 ± 3.5 vs. 6.5 ± 3.0; p < 0.001) and higher SOFA-48 scores (13.8 ± 4.2 vs. 5.2 ± 3.0; p < 0.001). ΔSOFA demonstrated worsening organ dysfunction among non-survivors compared with improvement among survivors (2.8 ± 3.6 vs. -1.3 ± 2.5; p < 0.001). ROC analysis showed an area under the curve (AUCs) of 0.79 for SOFA-0, 0.91 for SOFA-48, and 0.93 for ΔSOFA. A ΔSOFA cut-off of >+1.5 demonstrated 92.0% sensitivity and 81.0% specificity.

Serial SOFA assessment, particularly ΔSOFA, demonstrated strong prognostic utility for ICU mortality in patients with maxillofacial trauma. Early worsening of organ dysfunction may help identify patients at increased risk of poor outcomes.