Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring

Arts, Derk L.; Keizer, Nicolette F. de; Vroom, Margreeth B.; Jonge, Eric de

doi:10.1097/01.ccm.0000178178.02574.ab

Cited by 119 publications

(93 citation statements)

References 21 publications

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“…The SOFA was developed based on the degree of organ dysfunction. However, some publications have questioned the reliability of these scoring systems [12][13]. As expected, both the APACHE and SOFA scores were higher in patients with a poor outcome than in patients who survived, but only the SOFA score proved to be a predictor of death at time zero.…”

Section: Discussionmentioning

confidence: 76%

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Biomarkers in sepsis at time zero: intensive care unit scores, plasma measurements and polymorphisms in Argentina

Wingeyer

Cunto

Nogueras

et al. 2011

J Infect Dev Ctries

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Introduction: A patient's response to sepsis is influenced by their genetic background. Our objective was to use plasma markers, such as protein C (PC), D-dimer, Plasminogen Activator Inhibitor-1 (PAI-1) levels, and the PAI-1 rs1799889 4G/5G and Tumor Necrosis Factor-α rs1800629 G/A polymorphisms to improve classical intensive care unit (ICU) scores. Methodology: We studied 380 subjects, 166 with sepsis. We performed coagulation tests: plasma PAI-1 and PC levels were evaluated by chromogenic methods; and D-dimer was evaluated by immunoturbidimetric assay. Polymorphisms were performed using for polymerase chain reactions followed by digest with specific restriction enzyme. We acquired the APACHE and SOFA scores (time zero), sex, age, body mass index, associated co-morbidities, length of ICU stay (days), the severity of sepsis (sepsis, severe sepsis or septic shock), the HIV status and the ICU outcome (survival or death). Results: We found significant differences between patients who died (n=80) and those who survived (n=86) in terms of the ICU length of stay (6 vs. 10 days), septic shock (64 versus 24%), age (51 versus 38 years old), HIV+ condition (34 versus 16%), SOFA (7 versus 4), APACHE (19 versus 13), D-dimer (4.32 versus 2.88 g/ml), PC (46.0 versus 63.5 %) and PAI-1 (33.0 versus 16.5 UA/l). When we used a regression analysis with dichotomized variables, only the SOFA 4 , PAI-1 16 , HIV status and the PAI-1 4G allele proved to be predictors of death at time zero. Conclusions: In the future, ICU scores may be further improved by adding certain genomic or plasma data.

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Section: Discussionmentioning

confidence: 76%

“…However, some publications have questioned the insufficient reliability of these scoring systems [12][13]. In fact, many publications focused their attention on using the plasma levels of certain factors, such as protein C (PC), procalcitonin, TNF-, and plasminogen activator inhibitor-1 (PAI-1), as prognostic markers [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Biomarkers in sepsis at time zero: intensive care unit scores, plasma measurements and polymorphisms in Argentina

Wingeyer

Cunto

Nogueras

et al. 2011

J Infect Dev Ctries

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“…Where a data point was missing or not available for a component, a value was interpolated from surrounding data. In this study, the Glasgow Coma score reflecting central nervous system function was excluded due to its reported lack of robustness and unreliability (Hellawell et al 2000;Udekwu et al 2004;Arts et al 2005;Kerby et al 2007;Tallgren et al 2009), and it is thus not consistently recorded in Christchurch Hospital. Other studies have made a similar exclusion (Zygun et al 2006).…”

Section: Organ Failure Assessmentmentioning

confidence: 99%

Assessment of SOFA Score as a Diagnostic Indicator in Intensive Care Medicine

Hewett

Rodgers

Chase

et al. 2012

IFAC Proceedings Volumes

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Abstract:Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is assessed to evaluate its efficacy as a diagnostic indicator. Statistical analyses investigate the SOFA score distributions in the days leading up to patient mortality and patient discharge. It is found that the SOFA score is not an effective predictor of patient mortality, but it is a useful tool for prediction of patient discharge from the Intensive Care Unit (ICU). The distribution of overall SOFA score was observed not to change notably in the days leading up to patient death. However, the SOFA score distribution was observed to have a trend towards lower SOFA scores in the days leading up to patient discharge. Finally, assessment of the individual components of the overall SOFA score indicated that the coagulation and cardiovascular scores showed the highest correlation to mortality and are therefore the most useful individual groups to be used as diagnostic indicators.

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“…This challenge necessitates identification and validation of population-specific scores for organ/system dysfunction in patients with obstetric morbidity. The SOFA score offers several advantages [26][27][28][29][30]: it uses variables that can be easily measured without the need of very complex resources, proxy measures could be used in cases where complex or expensive variables cannot be measured, measurements can easily be standardized, and scores have high predictive and discriminatory ability in SMM. As in other studies [12][13][14][21][22][23][24]26], the maximum aggregated SOFA scores were prognostic, though in retrospect.…”

Section: Discussionmentioning

confidence: 99%

The Utility of the Sequential Organ Failure Assessment Score in Predicting Mortality in Critically Ill Obstetric Patients Admitted to a High Dependency Unit in Uganda

Kaye¹

2017

IPCB

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Background: Most maternal deaths result from severe maternal morbidity (SMM with subsequent organ/system dysfunction and organ failure. The objective was to assess the performance of Sequential Organ Failure Assessment (SOFA) score in cases of SMM admitted to the high dependency obstetric unit.Methods: Organ/system dysfunction and failure were assessed according to the maximum score for the six components (respiratory, neurological, renal, hepatic, cardiovascular and coagulation system). The total maximum SOFA score was estimated using the worst result each component on a single day. The distribution of SOFA scores was assessed for normality by using the Shapiro Wilk Test, [p=003]. The mean maximum SOFA scores for each organ/system were computed according to according to outcome (survival or death), using the Mann-Whitney test. The sensitivity, specificity, and the area under the curve (AUC) for each organ/system were evaluated. A Receiver Operator Characteristic (ROC) curve was fitted using maximum likelihood estimates for the total maximum SOFA score, in order to assess the sensitivity, specificity and discriminatory abilities of the maximum SOFA scores. Results:Of the 425 patients with SMM, 345 (81.2%, 95%CI 71.8-82.4) survived while 80 (18.8%, 95% CI: 12.9, 22.6) did not survive. All the non-survivors and 64 (18.5%) of the survivors presented with multiple organ/system dysfunction. Nonsurvivors were more likely to present with more severe and with multiple organ/ system dysfunction. The maximum total SOFA score had good discrimination in the respiratory, cardiovascular and neurological systems, but poor discrimination in the renal, hepatic and coagulatory systems. The total maximum SOFA score displayed an area under the curve (AUC) of 0.83 (95% CI: 0.56, 1.00), with a cutoff value of at least 8.0 sensitivity of 86.7%, and specificity of 90.0%. Conclusion:The total maximum SOFA score showed good predictive and discriminative abilities for maternal mortality in women with severe maternal morbidity.

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Reliability and accuracy of Sequential Organ Failure Assessment (SOFA) scoring

Abstract: The results of this study indicate that the reliability and the accuracy of SOFA scoring among physicians are good. We advise implementation of additional measures to further improve reliability and accuracy of SOFA scoring.

Cited by 119 publications

References 21 publications

Biomarkers in sepsis at time zero: intensive care unit scores, plasma measurements and polymorphisms in Argentina

Biomarkers in sepsis at time zero: intensive care unit scores, plasma measurements and polymorphisms in Argentina

Assessment of SOFA Score as a Diagnostic Indicator in Intensive Care Medicine

The Utility of the Sequential Organ Failure Assessment Score in Predicting Mortality in Critically Ill Obstetric Patients Admitted to a High Dependency Unit in Uganda

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