SOFA Score Better Predicts In-Hospital Mortality for Adults in ICU

Change of 2 or more points in SOFA score offers greater discrimination for in-hospital mortality.
Change of 2 or more points in SOFA score offers greater discrimination for in-hospital mortality.

HealthDay News — For patients with an infection-related primary admission to the intensive care unit (ICU), a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score offers greater discrimination for in-hospital mortality than systemic inflammatory response syndrome (SIRS) criteria or the quick SOFA (qSOFA) score, according to a study published in the Journal of the American Medical Association.

Eamon P. Raith, MBBS, from the Alfred Hospital in Melbourne, Australia, and colleagues conducted a retrospective analysis of 184,875 patients with an infection-related primary admission diagnosis. Data were reviewed for patients from 182 Australian and New Zealand ICUs from 2000 through 2015.

The researchers found that 18.7% of the patients died in the hospital. Overall, 90.1% had a SOFA score increase of 2 or more points; 86.7% manifested two or more SIRS criteria; and 54.4% had a qSOFA score of 2 or more points. Compared with SIRS criteria or qSOFA, SOFA demonstrated significantly greater discrimination for in-hospital mortality (area under the receiver operating characteristic curve, 0.753 vs 0.589 and 0.607, respectively; <.001). For the secondary end point of in-hospital mortality or ICU length of stay of 3 days or more, SOFA outperformed the other scores.

"These findings suggest that SIRS criteria and qSOFA may have limited utility for predicting mortality in an ICU setting," the authors write.

Reference

Raith EP, Udy AA, Bailey M, et al; Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resource Evaluation (CORE). Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA. 2017;317:290-300. doi: 10.1001/jama.2016.20328

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