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SOFA Score Predicts In-Hospital Mortality for Adults in ICU

Increase in SOFA score of 2 or more points offers greater discrimination than qSOFA, SIRS criteria

man on respirator

FRIDAY, Jan. 20, 2017 (HealthDay News) -- For patients with an infection-related primary admission to the intensive care unit (ICU), a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score offers greater discrimination for in-hospital mortality than systemic inflammatory response syndrome (SIRS) criteria or the quick SOFA (qSOFA) score, according to a study published online Jan. 17 in the Journal of the American Medical Association.

Eamon P. Raith, M.B.B.S., from the Alfred Hospital in Melbourne, Australia, and colleagues conducted a retrospective analysis of 184,875 patients with an infection-related primary admission diagnosis. Data were reviewed for patients from 182 Australian and New Zealand ICUs from 2000 through 2015.

The researchers found that 18.7 percent of the patients died in the hospital. Overall, 90.1 percent had a SOFA score increase of 2 or more points; 86.7 percent manifested two or more SIRS criteria; and 54.4 percent had a qSOFA score of 2 or more points. Compared with SIRS criteria or qSOFA, SOFA demonstrated significantly greater discrimination for in-hospital mortality (area under the receiver operating characteristic curve, 0.753 versus 0.589 and 0.607, respectively; P < 0.001). For the secondary end point of in-hospital mortality or ICU length of stay of three days or more, SOFA outperformed the other scores.

"These findings suggest that SIRS criteria and qSOFA may have limited utility for predicting mortality in an ICU setting," the authors write.

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