Investigating the Utility of the SOFA Score and Creating a Modified SOFA Score for Predicting Mortality in the Intensive Care Units in a Tertiary Hospital in Jordan.

IF 1.8 Q3 CRITICAL CARE MEDICINE
Anas H A Abu-Humaidan, Fatima M Ahmad, Laith S Theeb, Abdelrahman J Sulieman, Abdelkader Battah, Amjad Bani Hani, Mahmoud Abu Abeeleh
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引用次数: 1

Abstract

Background: The utility of the Sequential Organ Failure Assessment (SOFA) score in predicting mortality in the intensive care unit (ICU) has been demonstrated before, but serial testing in various settings is required to validate and improve the score. This study examined the utility of the SOFA score in predicting mortality in Jordanian ICU patients and aimed to find a modified score that required fewer laboratory tests.

Methods: A prospective observational study was conducted at Jordan University Hospital (JUH). All adult patients admitted to JUH ICUs between June and December 2020 were included in the study. SOFA scores were measured daily during the whole ICU stay. A modified SOFA score (mSOFA) was constructed from the available laboratory, clinical, and demographic data. The performance of the SOFA, mSOFA, qSOFA, and SIRS in predicting ICU mortality was assessed using the area under the receiver operating characteristic curve (AUROC).

Results: 194 patients were followed up. SOFA score (mean ± SD) at admission was significantly higher in non-survivors (7.5 ± 3.9) compared to survivors (2.4 ± 2.2) and performed the best in predicting ICU mortality (AUROC = 0.8756, 95% CI: 0.8117-0.9395) compared to qSOFA (AUROC = 0.746, 95% CI: 0.655-0.836) and SIRS (AUROC = 0.533, 95% CI: 0.425-0.641). The constructed mSOFA included points for the hepatic and CNS SOFA scores, in addition to one point each for the presence of chronic kidney disease or the use of breathing support; it performed as well as the SOFA score in this cohort or better than the SOFA score in a subgroup of patients with heart disease.

Conclusion: SOFA score was a good predictor of mortality in a Jordanian ICU population and better than qSOFA, while SIRS could not predict mortality. Furthermore, the proposed mSOFA score which employed fewer laboratory tests could be used after validation from larger studies.

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调查SOFA评分的效用并创建一个用于预测约旦三级医院重症监护病房死亡率的修改SOFA评分。
背景:序期器官衰竭评估(SOFA)评分在预测重症监护病房(ICU)死亡率方面的应用已被证实,但需要在不同环境下进行系列试验来验证和改进评分。本研究考察了SOFA评分在预测约旦ICU患者死亡率方面的效用,旨在找到一种需要较少实验室检查的修改评分。方法:在约旦大学医院(JUH)进行前瞻性观察研究。2020年6月至12月期间入住JUH icu的所有成年患者均纳入研究。在整个ICU住院期间每天测量SOFA评分。修改后的SOFA评分(mSOFA)是根据现有的实验室、临床和人口统计数据构建的。使用受试者工作特征曲线下面积(AUROC)评估SOFA、mSOFA、qSOFA和SIRS预测ICU死亡率的性能。结果:随访194例。非幸存者入院时SOFA评分(平均±SD)(7.5±3.9)明显高于幸存者(2.4±2.2),预测ICU死亡率(AUROC = 0.8756, 95% CI: 0.8117-0.9395)优于qSOFA (AUROC = 0.746, 95% CI: 0.655-0.836)和SIRS (AUROC = 0.533, 95% CI: 0.425-0.641)。构建的mSOFA包括肝脏和中枢神经系统SOFA评分,此外存在慢性肾脏疾病或使用呼吸支持各1分;它在该队列中的表现与SOFA评分一样好,或优于心脏病患者亚组中的SOFA评分。结论:SOFA评分能较好地预测约旦ICU人群的死亡率,且优于qSOFA,而SIRS不能预测死亡率。此外,拟议的mSOFA评分采用较少的实验室测试,可在更大规模的研究验证后使用。
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来源期刊
Critical Care Research and Practice
Critical Care Research and Practice CRITICAL CARE MEDICINE-
CiteScore
3.60
自引率
0.00%
发文量
34
审稿时长
14 weeks
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