Daily-Mean-SOFA, a New Derivative to Increase Accuracy of Mortality Prediction in Cardiac Surgical Intensive Care Units

Badreldin, Akmal M.A.; Elsobky, Sherif; Lehmann, Thomas; Brehm, B B; Doenst, Torsten; Hekmat, Khosro

doi:10.1055/s-0031-1295568

Cited by 17 publications

(23 citation statements)

References 14 publications

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“…The Cardiac Surgery Score (CASUS) was designed for predicting cardiac surgery mortality by using 10 variables measured upon ICU admission [23]. Several studies have concluded that the scale can effectively predict cardiac surgery mortality, and have recommended its use [24]. The CASUS also evaluates several organ functions and has similar parameters to those of SOFA.…”

Section: Discussionmentioning

confidence: 99%

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

et al. 2017

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BackgroundMortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality.MethodsBetween January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes, and prognostic model scores of the patients were collected. Discrimination was assessed using the area under the curve approach.ResultsBoth SOFA and APACHE II scores were effective for predicting in-hospital mortality. Among the organ systems examined in the SOFA, the cardiac and renal systems were the strongest predictors of CABG mortality. Multivariate analysis identified only the SOFA score as being an independent risk factor for mortality.ConclusionIn summary, the SOFA score can be used to accurately identify mortality after isolated CABG.

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Section: Discussionmentioning

confidence: 99%

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

et al. 2017

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“…The variables analyzed are: bilirubin, oxygenation, use of vasoactive drugs, values of mean arterial pressure and platelet count (18)(19) . For each function, a score of 3 or 4 indicates failure.…”

Section: Methodsmentioning

confidence: 99%

Avaliação da carga de trabalho no pós-operatório de cirurgia cardíaca segundo o Nursing Activities Score

Oliveira

Rodrigues

Püschel

et al. 2015

Rev. esc. enferm. USP

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RESUMO Objetivo Identificar os fatores associados à carga de trabalho de enfermagem no cuidado a pacientes no pós-operatório de cirurgia cardíaca. Método Estudo de coorte prospectivo, conduzido com 187 pacientes da Unidade de Terapia Intensiva Cirúrgica (UTI) do Instituto do Coração. Os dados foram coletados nas primeiras 24 e 72 horas do paciente na UTI. A variável dependente foi a carga de trabalho calculada por meio do Nursing Activities Score (NAS) e as independentes foram de natureza demográfico-clínicas e escores de morbimortalidade. Para análise dos dados utilizou-se os testes de Wilcoxon-Mann-Whitney e de correlação de Spearman, e a regressão linear com modelo de efeitos mistos. Resultados A maioria dos pacientes era do sexo masculino (59,4%), com média de idade de 61 anos (±12,7) e 43,9% desenvolveram algum tipo de complicação no pós-operatório. Nas 24 horas, a carga de trabalho foi de 82,4% (±3,4) e foi de 58,1% (±3,4) nas 72 horas. Os fatores associados ao aumento do NAS foram: tempo de internação do paciente na UTI (p=0,036) e a presença de complicações (p<0,001). Conclusão A gravidade do paciente nas 24 horas, em oposição a inúmeros estudos, não influenciou no aumento da carga de trabalho, a qual se mostrou associada ao tempo de internação e às complicações.

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“…The SOFA score, first shown to describe changing organ function in sepsis patients (2), has been since validated as a predictor of future organ dysfunction and mortality (4–6). Consisting of six individual organ dysfunction measures (i.e., respiratory, coagulation, liver, cardiovascular, neurologic, and renal), the SOFA is now widely used to assess the severity of illness in adult medical and surgical ICU patients (2, 4–7), as well as pediatric ICU patients (8). …”

Section: Introductionmentioning

confidence: 99%

Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale

Vasilevskis¹,

Pandharipande

Graves

et al. 2016

Critical Care Medicine

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Objective The Sequential Organ Failure Assessment (SOFA) and other severity of illness scales rely on the Glasgow Coma Scale (GCS) to measure acute neurologic dysfunction, but the GCS is unavailable or inconsistently applied in some institutions. The objective of this study was to assess the validity of a modified SOFA that uses the Richmond Agitation-Sedation Scale (RASS) instead of GCS. Design Prospective cohort study Setting Medical and surgical intensive care units within a large, tertiary care hospital. Patients Critically ill medical/surgical ICU patients. Interventions and measurements We calculated daily SOFA scores using electronic medical record-derived data. Using bedside nurse-recorded GCS and RASS measures, we calculated neurologic SOFA scores using the original GCS-based approach (SOFAGCS) and a novel RASS-based approach (SOFARASS), converting the 10-point RASS to a four-point neurologic SOFA score. We assessed construct validity of SOFARASS by analyzing correlations with established severity of illness constructs (APACHE II and SOFAGCS) and predictive validity by using logistic regression to determine whether SOFARASS predicts ICU, hospital, and 1-year mortality. We assessed discriminative performance with C-statistics. Main Results Among 513 patients (5,199 patient-days), SOFARASS was strongly correlated with APACHE II acute physiology score at enrollment (r = 0.583, 95% CI 0.518, 0.642) and daily SOFAGCS scores (r = 0.963, 95% CI 0.956 to 0.968). Mean SOFARASS scores predicted ICU mortality (AUC = 0.814)—as did mean SOFAGCS (0.799)—as well as hospital and 1-year mortality. Admission SOFA scores, whether using RASS or GCS were less accurate predictors of mortality; AUCs for ICU mortality for SOFARASS and SOFAGCS, for example, were 0.622 and 0.608, respectively. Conclusions A modified SOFA score that uses bedside RASS when GCS data are not available is a valid means of assessing daily severity of illness in the ICU and may be valuable for risk adjustment and benchmarking purposes.

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Daily-Mean-SOFA, a New Derivative to Increase Accuracy of Mortality Prediction in Cardiac Surgical Intensive Care Units

Abstract: The Daily-Mean-SOFA is a reliable derivative for daily risk stratification in cardiac ICUs. Due to its accuracy and daily availability, it may be used for risk-directed therapy in cardiac ICUs.

Cited by 17 publications

References 14 publications

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting

Avaliação da carga de trabalho no pós-operatório de cirurgia cardíaca segundo o Nursing Activities Score

Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale

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