Accuracy of SOFA score in prediction of 30-day outcome of critically ill patients

Saeed Safari; Majid Shojaee; Farhad Rahmati; Alireza Barartloo; Behrooz Hahshemi; Mohammad Mehdi Forouzanfar; Elham Mohammadi

doi:10.1016/j.tjem.2016.09.005

Saeed Safari¹, Majid Shojaee², Farhad Rahmati¹, Alireza Barartloo³, Behrooz Hahshemi¹, Mohammad Mehdi Forouzanfar¹, Elham Mohammadi¹

¹Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
²Emergency Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
³Emergency Department, Tehran University of Medical Sciences, Tehran, Iran

Keywords: Organ dysfunction scores; Prognosis; Patient outcome assessment; Critical illness; Emergency service; Hospital

Abstract

Objectives: Researchers have attempted to design various scoring systems to determine the severity and predict the outcome of critically ill patients. The present study aimed to evaluate the accuracy of SOFA score in predicting 1-month outcome of these patients in emergency department.

Methods: The present study is a prospective cross-sectional study of >18 year old non-trauma critically ill patients presented to EDs of 3 hospitals, Tehran, Iran, during October 2014 to October 2015. Baseline characteristics, SOFA score variables, and 1-month outcome of patients were recorded and screening performance characteristics of the score were calculated using STATA 11 software.

Results: 140 patients with the mean age of 68.36 ± 18.62 years (18–95) were included (53.5% male). The most common complaints were decrease in level of consciousness (76.43%) and sepsis (60.0%), were the most frequent final diagnoses. Mean SOFA score of the patients was 7.13 ± 2.36 (minimum 2 and maximum 16). 72 (51.43%) patients died during the following 30 days and 16 (11.43%) patients were affected with multiple organ failure. Area under the ROC curve of SOFA score in predicting mortality of studied patients was 0.73 (95%CI: 0.65–0.81) (Fig. 2). Table 2 depicts screening performance characteristics of this scale in prediction of 1-month mortality in the best cut-off point of ≥7. At this cut-off point, sensitivity and specificity of SOFA in predicting 1-month mortality were 75% and 63.23%, respectively.

Conclusion: Findings of the present study showed that SOFA scoring system has fair accuracy in predicting 1-month mortality of critically ill patients. However, until a more reliable scoring system is developed, SOFA might be useful for narrative prediction of patient outcome considering its acceptable likelihood ratios.