Use of the sequential organ failure: Assessment score as a severity score

• Published in: Intensive care medicine Vol. 31; no. 2; pp. 243 - 249
• Main Authors: KAJDACSY-BALLA AMARAL, André Carlos, MOREIRA ANDRADE, Fabio, MORENO, Rui, ARTIGAS, Antonio, CANTRAINE, Francis, VINCENT, Jean-Louis
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.02.2005; Berlin Springer Nature B.V
• Subjects: Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Clinical death. Palliative care. Organ gift and preservation; Emergency and intensive respiratory care; Female; Hospital Mortality; Humans; Infections; Intensive care; Intensive care medicine; Intensive Care Units; Logistic Models; Male; Medical sciences; Middle Aged; Mortality; Multiple Organ Failure - mortality; Patients; Physiology; Predictive Value of Tests; Prospective Studies; Regression analysis; Severity of Illness Index; Survival Rate; Infection; Intensive care; Outcome; Severity score; Organ dysfunction; Resuscitation; International
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-004-2528-6

To evaluate whether the SOFA score can be used to develop a model to predict intensive care unit (ICU) mortality in different countries. 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. 748 patients from six countries. 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%). 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.