Association of Sequential Organ Failure Assessment (SOFA) components with mortality.
Multiorgan Failure
SOFA
SOFA score
SOFA score components
SOFA score weights
Surrogate endpoint
Journal
Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
16
03
2022
received:
25
10
2021
accepted:
21
03
2022
pubmed:
31
3
2022
medline:
25
6
2022
entrez:
30
3
2022
Statut:
ppublish
Résumé
Sequential Organ Failure Assessment (SOFA) is a practical method to describe and quantify the presence and severity of organ system dysfunctions and failures. Some proposals suggest that SOFA could be employed as an endpoint in trials. To justify this, all SOFA component scores should reflect organ dysfunctions of comparable severity. We aimed to investigate whether the associations of different SOFA components with in-hospital mortality are comparable. We performed a study based on nationwide register data on adult patients admitted to 26 Finnish intensive care units (ICUs) during 2012-2015. We determined the SOFA score as the maximum score in the first 24 hours after ICU admission. We defined organ failure (OF) as an organ-specific SOFA score of three or higher. We evaluated the association of different SOFA component scores with mortality. Our study population comprised 63,756 ICU patients. Overall hospital mortality was 10.7%. In-hospital mortality was 22.5% for patients with respiratory failure, 34.8% for those with coagulation failure, 40.1% for those with hepatic failure, 14.9% for those with cardiovascular failure, 26.9% for those with neurologic failure and 34.6% for the patients with renal failure. Among patients with comparable total SOFA scores, the risk of death was lower in patients with cardiovascular OF compared with patients with other OFs. All SOFA components are associated with mortality, but their weights are not comparable. High scores of other organ systems mean a higher risk of death than high cardiovascular scores. The scoring of cardiovascular dysfunction needs to be updated.
Sections du résumé
BACKGROUND
Sequential Organ Failure Assessment (SOFA) is a practical method to describe and quantify the presence and severity of organ system dysfunctions and failures. Some proposals suggest that SOFA could be employed as an endpoint in trials. To justify this, all SOFA component scores should reflect organ dysfunctions of comparable severity. We aimed to investigate whether the associations of different SOFA components with in-hospital mortality are comparable.
METHODS
We performed a study based on nationwide register data on adult patients admitted to 26 Finnish intensive care units (ICUs) during 2012-2015. We determined the SOFA score as the maximum score in the first 24 hours after ICU admission. We defined organ failure (OF) as an organ-specific SOFA score of three or higher. We evaluated the association of different SOFA component scores with mortality.
RESULTS
Our study population comprised 63,756 ICU patients. Overall hospital mortality was 10.7%. In-hospital mortality was 22.5% for patients with respiratory failure, 34.8% for those with coagulation failure, 40.1% for those with hepatic failure, 14.9% for those with cardiovascular failure, 26.9% for those with neurologic failure and 34.6% for the patients with renal failure. Among patients with comparable total SOFA scores, the risk of death was lower in patients with cardiovascular OF compared with patients with other OFs.
CONCLUSIONS
All SOFA components are associated with mortality, but their weights are not comparable. High scores of other organ systems mean a higher risk of death than high cardiovascular scores. The scoring of cardiovascular dysfunction needs to be updated.
Identifiants
pubmed: 35353902
doi: 10.1111/aas.14067
pmc: PMC9322581
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
731-741Informations de copyright
© 2022 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
Références
Crit Care Med. 2019 Dec;47(12):1680-1691
pubmed: 31567349
JAMA. 2017 Jan 17;317(3):290-300
pubmed: 28114553
Crit Care. 2017 Feb 24;21(1):38
pubmed: 28231816
Crit Care Med. 2009 May;37(5):1649-54
pubmed: 19325482
Crit Care Med. 2011 Feb;39(2):259-65
pubmed: 20975548
Crit Care Med. 2019 Apr;47(4):535-542
pubmed: 30608280
Chest. 1993 Jul;104(1):230-5
pubmed: 8325076
Crit Care. 2019 Nov 29;23(1):387
pubmed: 31783881
Anaesth Intensive Care. 2017 Nov;45(6):737-743
pubmed: 29137585
Intensive Care Med. 2017 May;43(5):625-632
pubmed: 28130687
JAMA. 1993 Dec 22-29;270(24):2957-63
pubmed: 8254858
Shock. 2020 Apr;53(4):452-459
pubmed: 31169766
Intensive Care Med. 2002 Nov;28(11):1619-24
pubmed: 12415450
Transpl Int. 2016 Sep;29(9):974-84
pubmed: 26563531
Eur Heart J. 2016 Jul 14;37(27):2129-2200
pubmed: 27206819
BMC Pharmacol Toxicol. 2016 May 07;17(1):19
pubmed: 27154548
Acta Anaesthesiol Scand. 2022 Jul;66(6):731-741
pubmed: 35353902
Intensive Care Med. 2018 Jun;44(6):857-867
pubmed: 29872882
Crit Care. 2019 Nov 27;23(1):374
pubmed: 31775846
Crit Care Med. 2010 Oct;38(10 Suppl):S534-8
pubmed: 21164394
PLoS One. 2019 May 20;14(5):e0216177
pubmed: 31107889
Crit Care Med. 1985 Oct;13(10):818-29
pubmed: 3928249
Ann Intensive Care. 2019 Jan 30;9(1):20
pubmed: 30701448
Crit Care Med. 2005 Oct;33(10):2194-201
pubmed: 16215369
Acta Anaesthesiol Scand. 2018 Apr;62(4):420-450
pubmed: 29479665
Ann Surg. 1985 Dec;202(6):685-93
pubmed: 4073980
Crit Care. 2019 Feb 28;23(1):67
pubmed: 30819234
Intensive Care Med. 2022 Jan;48(1):119-120
pubmed: 34596703
Crit Care Med. 1998 Nov;26(11):1793-800
pubmed: 9824069
Acta Anaesthesiol Scand. 2012 Oct;56(9):1114-22
pubmed: 22384799
Intensive Care Med. 2005 Feb;31(2):243-9
pubmed: 15668764
Medicine (Baltimore). 2018 Oct;97(41):e12769
pubmed: 30313090
Clin Nutr. 2021 Aug;40(8):4932-4940
pubmed: 34358839
J Intensive Care Med. 2020 Aug;35(8):810-817
pubmed: 30165769
Intern Emerg Med. 2018 Apr;13(3):405-412
pubmed: 28188577
Crit Care Med. 2004 May;32(5 Suppl):S209-13
pubmed: 15118519
Intensive Care Med. 1996 Jul;22(7):707-10
pubmed: 8844239
Intensive Care Med. 1999 Jul;25(7):686-96
pubmed: 10470572