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Use of the Sequential Organ Failure Assessment score as a severity score

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Abstract

Objective

To evaluate whether the SOFA score can be used to develop a model to predict intensive care unit (ICU) mortality in different countries.

Design and setting

Analysis of a prospectively collected database. Patients with ICU stay longer than 2 days were studied to develop a mortality prediction model based on measurements of organ dysfunction.

Patients

748 patients from six countries.

Measurements and results

Two logistic regression models were constructed, one based on the SOFA maximum (SOFA Max model) and the other on variables identified by multivariate regression (SOFA Max-infection model). The H and C statistics had a p value above 0.05 for both models, but the D statistics showed a poor performance on the SOFA Max model when stratified for the presence of infection. Subsequent analysis was performed with SOFA Max-infection model. The area under the curve was 0.853. There were no statistically significant differences in observed and predicted mortalities except for one country which had a higher than predicted ICU mortality both in the overall population (28.3 vs. 19.1%) and in the noninfected patients (21.4 vs. 12.6%).

Conclusions

The SOFA Max adjusted for age and the presence of infection can predict mortality in this population, but in one country the ICU mortality was higher than expected. Our data do not allow us to determine the reasons behind these differences, and further studies to detect differences in mortality between countries and to elucidate the basis for these differences should be encouraged.

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Authors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium

    André Carlos Kajdacsy-Balla Amaral, Fábio Moreira Andrade & Jean-Louis Vincent

  2. Department of Intensive Care, Hospital de St. António dos Capuchos, Portugal

    Rui Moreno

  3. Critical Care Center, Sabadell Hospital, Red GIRA G03/063, Parc Tauli University Institute, Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain

    Antonio Artigas

  4. School of Medicine, Free University of Brussels, Brussels, Belgium

    Francis Cantraine

Authors
  1. André Carlos Kajdacsy-Balla Amaral
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  2. Fábio Moreira Andrade
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  3. Rui Moreno
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  4. Antonio Artigas
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  5. Francis Cantraine
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  6. Jean-Louis Vincent
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Correspondence to Jean-Louis Vincent.

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Kajdacsy-Balla Amaral, A.C., Andrade, F.M., Moreno, R. et al. Use of the Sequential Organ Failure Assessment score as a severity score. Intensive Care Med 31, 243–249 (2005). https://doi.org/10.1007/s00134-004-2528-6

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  • DOI: https://doi.org/10.1007/s00134-004-2528-6

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