Volume 19 Supplement 2
Evolutive analysis of the SOFA score in critically ill massive burn patients during their stay in the ICU
© de Campos et al. 2015
Published: 28 September 2015
It is estimated that multiple organ dysfunction could be responsible for 80 % of mortality in critically ill burn patients, mainly related to sepsis. However, there are no recommendations for monitoring organ dysfunction during the stay of burn patients in the ICU.
Our aim was to analyze and characterize organ dysfunction by the Sequential Organ Failure Assessment (SOFA) score in massive burn patients during their stay in the ICU with the hypothesis that survivors diverge from nonsurvivors during the length of stay in the ICU.
Retrospective cohort study employing data collected from May 2005 to April 2010 at an ICU specializing in burn patients at a teaching hospital. All patients admitted during this period were included. Data for physiological and epidemiological variables were collected at admission. During the ICU evaluation, the total SOFA score with its components were recorded from the first day to the seventh day. It was also recorded on the 14th, 21st and 28th days if the patient stayed in the ICU. The clinical outcomes collected were the ICU length of stay, hospital length of stay, and ICU and hospital mortality.
One hundred and sixty-three consecutive patients were studied (male: 71 %), with median age of 34 (25, 47) years and a hospital stay of 29 (11, 50) days. Incidence of inhalation injury was 45 % and total burn surface area (%) was 29 (18, 43). The total SOFA score at admission in survivor patients was 1 (1, 4) and in nonsurvivors was 7 (4, 9) (P <0.05). Significant difference related to the total SOFA score was found during all other days analyzed. The analysis in the first 7 days with the receiver operating characteristic curve of worst individual organ dysfunction quantified through the total SOFA score and partitioned SOFA score showed good capacity to discriminate survivors and nonsurvivors between the respiratory, cardiovascular, renal and hematological components. Hepatic and neurological components did not present a good performance.
In our study, organ dysfunction quantified by total SOFA score and respiratory, cardiovascular, renal and hematological partitions was different between survivors and nonsurvivors during the ICU evolution.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.