Daily SOFA scoring for ICU patients?

Introduction

SOFA might be a useful tool for monitoring of organ function in ICU patients [1]. We evaluated optimal frequency of SOFA acquisition in long term ICU patients (i.e. patients staying in the ICU >3 days).

Materials and methods

Daily SOFA scores of ICU patients admitted between July and November 1998 who stayed in the ICU >3 days were retrieved from the data collection system. An experienced ICU doctor has collected SOFA scores into this system daily. Original daily SOFA score flow charts and adapted (simplified) SOFA score flow charts (SOFA on days 1, 4, 7, 10, 14, 21, 24, 28 etc.; i.e. values of unlisted days expressed as trends between data collection days) were compared for individuals and the whole group of patients. Data are presented as means ± SD; P < 0.05 was considered significant.

Results

Sixty-two patients (i.e. 42% out of total admissions; age 60.0 ± 14.7 years) fulfilled the inclusion criteria and stayed in the ICU for the mean of 11.9 ± 10.8 days. ICU mortality was 30.6% (19 patients). Original and adapted data did show equal values for the whole group of patients (MANOVA group by time effect 0.98 at Day 4, 62 patients and 1.00 at Day 7, 36 patients). Out of total 736 ICU days, in 374 there was theoretical possibility of data difference (adapted SOFA scores). Significant difference (defined as ?SOFA >2) between original and adapted values was found in 64 cases (17.1%) In 30 cases adapted values were higher then original ones.

Conclusion

SOFA score collected 2-3 times a week describes sufficiently characteristics of long term ICU patients. Significant individual data might be lost when SOFA score is not collected on daily basis.