- Poster presentation
- Open Access
Sequential Organ Failure Assessment in pandemic planning
© BioMed Central Ltd. 2010
- Published: 1 March 2010
- Hospital Mortality
- Sequential Organ Failure Assessment
- Diagnostic Category
- Sequential Organ Failure Assessment Score
- Triage Protocol
The H1N1 pandemic has highlighted the importance of reliable and valid triage instruments for scarce resources during periods of high demand. Christian and colleagues have proposed a triage protocol that utilizes a Sequential Organ Failure Assessment (SOFA) score >11 to exclude patients from critical care resources quoting an associated mortality of more than 90% . We sought to assess the hospital mortality associated with this SOFA threshold and the resource implications of such a triage protocol.
This retrospective cohort study included consecutive ICU patients admitted to any one of our three tertiary-care adult multisystem ICUs from January 2003 to December 2008. Patients were excluded if they were admitted for routine postoperative monitoring (ICU stay <48 hours) or postoperative cardiac surgery. SOFA was collected daily by an electronic bedside clinical information system (QS; GE Medical Systems).
A SOFA score >11 was not associated with a hospital mortality >90% at any time during the ICU stay. Age and diagnostic category represent potential modifying factors in the association of SOFA >11 and hospital mortality. Only a small proportion of patients have the extreme initial SOFA values associated with a hospital mortality >90%, limiting the usefulness of SOFA as a triage instrument for pandemic planning.