- Poster presentation
- Open Access
Expanded Multiple Organ Dysfunction score: is it better than the Sequential Organ Failure Syndrome score?
© BioMed Central Ltd 2006
- Published: 21 March 2006
- Mechanical Ventilation
- Serum Creatinine
- Acute Renal Failure
- Outcome Prediction
- Vital Status
In our database, the day 1 Sequential Organ Failure Syndrome (SOFA) score performs significantly better than day 1 Multiple Organ Dysfunction score (MODS) in outcome prediction (data not published). The Expanded Multiple Organ Dysfunction score (EMODS) is a simple modification of MODS. It is calculated by summing up MODS with the Organ Support/Failure Score (OS-F). The OS-F is a dichotomous score of 1 or 0, given to each organ support/failure the patient received, namely: mechanical ventilation present at the 24th hour of admission, inotropes for more than 1 hour/day, transfusion and serum creatinine >200 μmol/l. The Maximum score a patient could receive is 4. The above modifications seem necessary for MODS as it does not account for therapeutic interventions.
To compare performances of EMODS with SOFA in outcome prediction.
Retrospective analysis of prospectively collected data as part of the APRiMo study .
All critically ill obstetric patients admitted to our independent multidisciplinary ICU were included. Exclusion criteria: length of stay <24 hours. Necessary data for calculation of the MODS, SOFA and OS-F Score at the first day of ICU hospitalization were available. Main outcome of interest: vital status at ICU discharge. Performances of EMODS and SOFA were assessed using adequate statistical tests.
0.9 ± 0.07
0.913 ± 0.05*
0.922 ± 0.05†
EMODS sensitivity was significantly better than MODS and performed at least as well as the SOFA score. Adding organ support enhanced the performance of MODS, sustaining organ dysfunction/failure assessment with SOFA (which involves mechanical ventilation and use of inotropes) is a better way to evaluate respiratory and hemodynamic dysfunctions. The choice of transfusion as an additional criterion to assess hematologic dysfunction is pertinent in our particular case mix. After computing a logistic regression model with OS-F components, single-component MODS, with vital status as the dependent variable; a serum creatinine level >200 μmol/l gave an OR of 23. This emphasizes again the importance of acute renal failure as a prognostic factor in the ICU, but also rises again the question about the optimal parameter to evaluate renal organ dysfunction.