Prognostics index: evaluation of Sequential Organ Failure Assessment and Multiple Organ Dysfunction Score in patients after cardiac arrest in intensive care

Introduction

Cardiac arrest is a frequent event that generates considerable exacerbation of the morbidity index of patients in the intensive care unit.

Objective

To assess the variation of the Sequential Organ Failure Assessment (SOFA) index and the Multiple Organ Dysfunction Score (MODS) index as morbidity predictors after cardiac arrest.

Patients and methods

The indexes SOFA and MODS were calculated for 40 patients that suffered cardiac arrest in the intensive care unit; the indexes were calculated based on laboratory values and clinical data obtained 24 hours before and after cardiac arrest.

Results

Forty patients, 17 (42.5%) female and 23 (57.5%) male, whose age varied from 17 to 84 years (mode 76 years). The causes of cardiac arrest were shock and metabolic disorders in 18 patients (45%), hypoxemia in 16 (40%), and myocardial ischaemia and poisoning by drugs in six patients (15%). The modality of arrest was asystolia in 17 patients (42.5%), pulseless electrical activity in 14 (35%) and ventricular fibrillation in nine patients (22.5%). The Acute Pysiology and Chronic Health Evaluation II score varied from 2 to 47 (mean 21, mode 11), and the mean risk of mortality was 32.54%. The previous SOFA score varied from 6 to 16 (mode 8) and that after arrest from 8 to 18 (mode 14). The MODS score varied from 3 to 16 (mode 7) and that after arrest from 5 to 21 (mode 12). In statistical analysis using the Wilcoxon test, the increase of the SOFA and MODS indexes after cardiac arrest was significant (z_calc = 5.33 or P < 0.001), but in a nonparametric comparison between the two indexes we noticed that the proportional increase of each one in the same patient occurred only in 21% of the patients.

Conclusion

The SOFA and MODS indexes were separately demonstrated to be good predictors of major morbidity of patients after cardiac arrest, but they did not as correlate variables for the same situation.