The Sequential Organ Failure Assessment Score Predicts 30-Day Mortality in a Geriatric Acute Care Setting

Mazzola, Paolo; Bellelli, Giuseppe; Perego, S.; Zambon, Antonella; Mazzone, Andrea; Bruni, Adriana Antonella; Annoni, Giorgio

doi:10.1093/gerona/glt020

Cited by 15 publications

(8 citation statements)

References 32 publications

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“…Our data contribute to understanding whether knowledge about the extent of premorbid deficit accumulation adds prognostic value in acutely ill patients ( 28–32 ). An important part of understanding prognosis is in needing to advise people about near-term outcomes of hospital admission for frail older adults who are acutely ill ( 28–30 , 40 ). For this reason, examining older patients who died within days to months is of particular interest.…”

Section: Discussionmentioning

confidence: 99%

Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit

Zeng

Song

Dong

et al. 2015

GERONA

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Background.In older adults admitted to intensive care units (ICUs), frailty influences prognosis. We examined the relationship between the frailty index (FI) based on deficit accumulation and early and late survival.Methods.Older patients (≥65 years) admitted to a specialized geriatric ICU at the Liuhuaqiao Hospital, Guangzhou, China between July–December 2011 (n = 155; age 82.7±7.1 y; 87.1% men) were followed for 300 days. The FI was calculated as the proportion present of 52 health deficits. FI performance was compared with that of several prognostic scores.Results.The 90-day death rate was 38.7% (n = 60; 27 died within 30 days). The FI score was correlated with the Glasgow Coma Scale, Karnofsky Scale, Palliative Performance Scale, Acute Physiology Score—APACHE II and APACHE IV (r 2 = 0.52 to 0.72, p < 0.001). Patients who died within 30 days had higher mean FI scores (0.41±0.11) than those who survived to 300 days (0.22±0.11; F = 38.91, p < 0.001). Each 1% increase in the FI from the previous level was associated with an 11% increase in the 30-day mortality risk (95% CI: 7%–15%) adjusting for age, sex, and the prognostic scores. The FI discriminated patients who died in 30 days from those who survived with moderately high accuracy (AUC = 0.89±0.03). No one with an FI score >0.46 survived past 90 days.Conclusion.ICU survival was strongly associated with the level of frailty at admission. An FI based on health deficit accumulation may help improve critical care outcome prediction in older adults.

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Section: Discussionmentioning

confidence: 99%

Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit

Zeng

Song

Dong

et al. 2015

GERONA

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“…Malnutrition was assessed using the MNA short-form and illness severity using the Sequential Organ Failure Assessment (SOFA). 2 Dementia was defined by reviewing previous clinical and neuropsychological charts and based on Mini-Mental State Examination (MMSE) scores. Presence of delirium at the time of admission was diagnosed using the Confusion Assessment Method (CAM) algorithm.…”

Section: Mini Nutritional Assessment and Functional Status As Predictmentioning

confidence: 99%

“…To the Editor: Adverse outcomes after elective surgery, including postoperative complications and long length of stay (LOS), are more common in older than in younger persons 1 but are correlated less with older age itself than with frailty and higher comorbidity in this population. [2][3][4] Geriatric assessment tools and comorbidity scores are validated predictors of postoperative complication risk. 5 Some risk factors that geriatric assessments identify are potentially modifiable through optimization of functional impairments and medical comorbidities.…”

Section: Preoperative Comprehensive Geriatric Assessment: Outcomes Inmentioning

confidence: 99%

Mini Nutritional Assessment and Functional Status As Predictors of Development of Pressure Ulcers in Acute Setting of Care

Mazzone

Bellelli

Annoni

2014

J American Geriatrics Society

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“…The SICU patients had a median baseline SOFA score of 4 (IQR, 3-9) and a median APACHE II score of 16 (IQR,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). A significant cutoff point for SOFA score has not yet been established, although SOFA score cutoffs in predicting mortality are reported to range from 2 to 7.…”

Section: Discussionmentioning

confidence: 99%

“…A significant cutoff point for SOFA score has not yet been established, although SOFA score cutoffs in predicting mortality are reported to range from 2 to 7. [13][14][15] APACHE II score cutoffs of 10-24 are reported to have high sensitivity and specificity in predicting clinical outcomes. [16][17][18] Considering the roles of SOFA and APACHE II scores in determining disease severity, the SICU patients in the present study were regarded as having moderately severe disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit

Pih

Hong

et al. 2020

Clin Endosc

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Background/Aims: Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW. Methods: The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed. Results: The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m 2. In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073). Conclusions: PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery. Clin Endosc 2020 Mar 31.

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The Sequential Organ Failure Assessment Score Predicts 30-Day Mortality in a Geriatric Acute Care Setting

Abstract: The SOFA score, a user-friendly tool used in intensive care units to estimate prognosis, is able to predict 1-month mortality also in patients admitted to an acute geriatric setting.

Cited by 15 publications

References 32 publications

Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit

Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit

Mini Nutritional Assessment and Functional Status As Predictors of Development of Pressure Ulcers in Acute Setting of Care

Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit

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