Utility of SOFA and Δ-SOFA scores for predicting outcome in critically ill patients from the emergency department

García-Gigorro, Renata; Fuente, Ignacio Sáez-de la; Mateos, H. Marín; Andrés-Esteban, Eva María; Sánchez-Izquierdo, José Ángel; Montejo-González, Juan Carlos

doi:10.1097/mej.0000000000000472

Cited by 39 publications

(37 citation statements)

References 21 publications

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“…Clinical outcomes reviewed were: length of ventilation, length of ICU stays, ICU mortality, inpatient mortality, risk of major internal bleeding, and occurrence of major thromboembolic events such as, pulmonary embolism and deep venous thrombosis. The Sequential Organ Failure Assessment (SOFA) score is a widely used and most accepted form of mortality prediction tool [11]. Clinical improvement was assessed using a Delta SOFA score, which is the difference between the SOFA scores at admission and SOFA scores at the 4 th (average ICU stay days), 7 th , and 10 th day after ICU admission [11].…”

Section: Methodsmentioning

confidence: 99%

“…The Sequential Organ Failure Assessment (SOFA) score is a widely used and most accepted form of mortality prediction tool [11]. Clinical improvement was assessed using a Delta SOFA score, which is the difference between the SOFA scores at admission and SOFA scores at the 4 th (average ICU stay days), 7 th , and 10 th day after ICU admission [11]. The effect of the blood thinners on Delta SOFA scores was assessed with the proportional hazard ratios and adjusted…”

Section: Methodsmentioning

confidence: 99%

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Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Bastola¹,

Locatis²,

Fontelo³

2020

Preprint

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Introduction: Critical care patients are at higher risk for thromboembolic disorders. There are limited studies regarding the effect of Heparin, Warfarin, Enoxaparin and Aspirin on ventilated patients, who are likely to both benefit from prophylaxis and suffer from adverse effects of blood thinners. Methods: This study analyzed the MIMIC-III clinical database on 4192 ventilated patients using Statistical Analysis Software (SAS, Version 9.4). Relevant data was systematically analyzed on the thromboprophylaxis agents and their effects on major treatment outcomes. Parameters studied were the length of ventilation, length of Intensive Care Unit (ICU) stays, ICU mortality, inpatient mortality, improvement in SOFA score, and occurrence of major thromboembolic events such as pulmonary embolism (PE) and deep venous thrombosis (DVT). Results: Except Aspirin, all thromboprophylactic agents showed statistically significant reduction on ICU mortality. None of the blood thinners showed statistically significant reduction in occurrences of pulmonary embolism and deep venous thrombosis. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.59(p<0.01, 0.47-0.77), 0.23(p<0.05, 0.1-0.57) and 0.36(P<0.05, 0.16-0.83) for ICU mortality. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.51(p<0.01, 0.38-0.68), 0.19(p<0.01, 0.06-0.59) and 0.42(P=0.06, 0.17-1.05) for overall ventilated patient hospital mortality, including after transfers to the inpatient ward.. Only Heparin (P<0.05, OR 1.52(1.07-2.15)) was associated with thrombocytopenia episodes, which required platelets transfusion. None of the drugs showed statistically significant relationships with development of thromboembolic events after thromboprophylaxis. Only Heparin had mild effect on improvement in sequential organ failure assessment (delta SOFA) scores at 7 and 10 day after ICU admission (P<0.05, OR 1.17 (1.03-1.32)). Conclusion: Although the results supported the use of thromboprophylaxis in ventilated patients to improve treatment outcomes and decrease thromboembolic events, no benefits were indicated for using newer blood thinners (Enoxaparin) than older ones (Heparin & Warfarin). The results of this analysis might help practitioners select, maintain, and switch blood thinners in ventilated patients.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Bastola¹,

Locatis²,

Fontelo³

2020

Preprint

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“…Primary clinical outcomes reviewed were: length of ventilation, length of ICU stays, ICU mortality, inpatient mortality, SOFA scores, risk of major internal bleeding, and occurrence of major thromboembolic events such as, pulmonary embolism and deep venous thrombosis. The Sequential Organ Failure Assessment (SOFA) score is a widely used and most accepted form of mortality prediction tool [11]. Clinical improvement was assessed using a Delta SOFA score, which is the difference between the SOFA scores at admission and SOFA scores at the 4th (average ICU stay days), 7th, and 10th day after ICU admission [11].…”

Section: Methodsmentioning

confidence: 99%

Thromboprophylaxis, Delta Sofa and Main Outcomes in Ventilated Patients: an Analysis of the MIMIC-III Clinical Database

Bastola

Locatis

Fontelo

2020

Preprint

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Introduction: Critical care patients are at higher risk for thromboembolic disorders. There are limited studies regarding the effect of Heparin, Warfarin, Enoxaparin and Aspirin on ventilated patients, who are likely to both benefit from prophylaxis and suffer from adverse effects of blood thinners. Methods: This study analyzed the MIMIC-III clinical database on 4192 ventilated patients using Statistical Analysis Software (SAS, Version 9.4). Relevant data was systematically analyzed on the thromboprophylaxis agents and their effects on major treatment outcomes. Parameters studied were the length of ventilation, length of Intensive Care Unit (ICU) stays, ICU mortality, inpatient mortality, improvement in SOFA score, and occurrence of major thromboembolic events such as pulmonary embolism (PE) and deep venous thrombosis (DVT). Results: Except Aspirin, all thromboprophylactic agents showed statistically significant reduction on ICU mortality. None of the blood thinners showed statistically significant reduction in occurrences of pulmonary embolism and deep venous thrombosis. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.59(p<0.01, 0.47-0.77), 0.23(p<0.05, 0.1-0.57) and 0.36(P<0.05, 0.16-0.83) for ICU mortality. Heparin, Warfarin and Enoxaparin had adjusted Odds ratios of 0.51(p<0.01, 0.38-0.68), 0.19(p<0.01, 0.06-0.59) and 0.42(P=0.06, 0.17-1.05) for overall ventilated patient hospital mortality, including after transfers to the inpatient ward.. Only Heparin (P<0.05, OR 1.52(1.07-2.15)) was associated with thrombocytopenia, which required platelet transfusion. None of the drugs showed statistically significant relationships with development of thromboembolic events after thromboprophylaxis. Only Heparin had mild effect on improvement in sequential organ failure assessment (delta SOFA) scores at 7 and 10 day after ICU admission (P<0.05, OR 1.17 (1.03-1.32)). Conclusion: Although the results supported the use of thromboprophylaxis in ventilated patients to improve treatment outcomes and decrease thromboembolic events, no benefits were indicated for using newer blood thinners (Enoxaparin) than older ones (Heparin & Warfarin). Heparin is related to both higher episodes of platelets transfusion and improvement of delta SOFA scores at end of first week of ICU admission. If validated by future research, the findings of this study might help practitioners and researchers to better understand thromboprophylaxis in ventilated patients.

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“…Further study is required to examine the prognostic value of these SOFA-derived score in heart failure settings. @ [23][24][25] Third, we evaluated LVEF of patients by 2-D echocardiography since all patients were not evaluated by m-Simpson echocardiography. Finally, information about medication changes, clinical events following hospital discharge, and cause of death was not available.…”

Section: Limitationsmentioning

confidence: 99%

Sequential organ failure assessment score on admission predicts long‐term mortality in acute heart failure patients

et al. 2020

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Aims The sequential organ failure assessment (SOFA) score has been a widely used predictor of outcomes in the intensive care unit, whereas short‐term and long‐term survivals of heart failure (HF) patients are predicted by the American Heart Association Get With the Guidelines–Heart Failure (GWTG‐HF) risk score. The purpose of present study was to examine whether the SOFA score on admission is more useful for predicting long‐term mortality in acute HF patients than the GWTG‐HF risk score. Methods and results A total of 269 patients (mean age, 78.5 ± 10.9 years; all‐cause mortality, 53.9%) seen in a single facility from January 2007 to December 2016 were enrolled retrospectively. They were followed up for a mean of 32.1 ± 22.3 months. All‐cause death was associated with higher SOFA and GWTG‐HF risk scores. However, no significant difference was observed in the area under the curve value between the scores. Kaplan–Meier survival analysis indicated that higher SOFA scores (P < 0.001) and GWTG‐HF risk scores (P < 0.001) were related to increased probabilities of all‐cause death. On multivariate Cox proportional hazard model analysis, the SOFA score (P < 0.001) and GWTG‐HF (P < 0.001) score were independent predictors of all‐cause death. Incorporating the SOFA score into the GWTG‐HF risk score yielded a significant net reclassification improvement and integrated discrimination improvement. On decision curve analysis, the net benefit of the SOFA score model when compared with the reference model was greater across the range of threshold probabilities. Conclusions In acute HF patients, long‐term all‐cause mortality can be predicted by the SOFA score. Discriminative performance metrics, such as net reclassification improvement, integrated discrimination improvement, and decision curve analysis, for predicting mortality were improved when the SOFA score was incorporated.

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Utility of SOFA and Δ-SOFA scores for predicting outcome in critically ill patients from the emergency department

Abstract: SOFA and changes in the SOFA score over time are potentially useful tools for risk stratification when applied to critically ill patients admitted to ICUs from the ED.

Cited by 39 publications

References 21 publications

Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Thromboprophylaxis, Delta Sofa and Main Outcomes in Ventilated Patients: an Analysis of the MIMIC-III Clinical Database

Sequential organ failure assessment score on admission predicts long‐term mortality in acute heart failure patients

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Utility of SOFA and Δ-SOFA scores for predicting outcome in critically ill patients from the emergency department

Abstract: SOFA and changes in the SOFA score over time are potentially useful tools for risk stratification when applied to critically ill patients admitted to ICUs from the ED.

Cited by 39 publications

References 21 publications

Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Thromboprophylaxis, Delta SOFA and Main Outcomes in Ventilated Patients: An Analysis of the MIMIC-III Clinical Database

Thromboprophylaxis, Delta Sofa and Main Outcomes in Ventilated Patients: an Analysis of the MIMIC-III&nbsp;Clinical Database

Sequential organ failure assessment score on admission predicts long‐term mortality in acute heart failure patients

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Thromboprophylaxis, Delta Sofa and Main Outcomes in Ventilated Patients: an Analysis of the MIMIC-III Clinical Database