Evaluation of the SOFA (Sepsis-related Organ Failure Assessment) Score in 303 consecutive patients of a medical intensive care unit

Objectives

The SOFA (sepsis-related organ failure assessment) score describes quantitatively the degree of organ dysfunction. Although primarily not designed to prediet outcome any assessment of morbidity must be related to mortality to some degree. We therefore investigated whether an increasing SOFA score is associated with a higher hospital mortality in patients (pts) of a medical intensive care unit (ICU).

Methods

All consecutive pts who stayed >24 h in ICU were included in this prospective study between 11/97 and 2/98. SOFA score and SAPS II were determined after 24 h. Discrimination power of the scores for survivors (S) and non-survivors (NS) [hospital mortality] was assessed by the area under the Receiver Operating Characteristic (AUROC) curve.

Results

303 pts (216 male [71.3%], 62 ± 12 years, length of ICU stay 3.7 ± 4.7 days, SOFA 2.5 ± 2.9, SAPS II 26 ± 12.6) were studied. Hospital mortality was 14.5%. SOFA score for NS was significantly higher than for S (5.9 ± 3.7 vs. 1.9 ± 2.3, P < 0.05). The AUROC was 0.82 ± 0.04 for the SOFA score and 0.77 ± 0.04 for SAPS II.

Conclusion

SOFA score discriminates well between S and NS24 h after admission. Respiration, liver and coagulation showed an increasing mortality rate with a higher SOFA score for each organ. Although the SOFA score was primarily designed for use in septic patients it may be also applied for pts of a medical intensive care unit.

Figure.

Mortality (%) versus SOFA score.