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Original Article10-31-2024
Analyzing how the components of the SOFA score change over time in their contribution to mortality
- Barbara D. Lam
, - Tristan Struja ,
- Yanran Li ,
- João Matos ,
- Ziyue Chen , [ ... ],
- Jesse Raffa
Abstract
Original ArticleAnalyzing how the components of the SOFA score change over time in their contribution to mortality
Critical Care Science. 2024;36:e20240030en
DOI 10.62675/2965-2774.20240030-en
- Barbara D. Lam ,
- Tristan Struja ,
- Yanran Li ,
- João Matos ,
- Ziyue Chen ,
- Xiaoli Liu ,
- Leo Anthony Celi ,
- Yugang Jia ,
- Jesse Raffa
Views131ABSTRACT
Objective:
Determine how each organ component of the SOFA score differs in its contribution to mortality risk and how that contribution may change over time.
Methods:
We performed multivariate logistic regression analysis to assess the contribution of each organ component to mortality risk on Days 1 and 7 of an intensive care unit stay. We used data from two publicly available datasets, eICU Collaborative Research Database (eICU-CRD) (208 hospitals) and Medical Information Mart for Intensive Care IV (MIMIC-IV) (1 hospital). The odds ratio of each SOFA component that contributed to mortality was calculated. Mortality was defined as death either in the intensive care unit or within 72 hours of discharge from the intensive care unit.
Results:
A total of 7,871 intensive care unit stays from eICU-CRD and 4,926 intensive care unit stays from MIMIC-IV were included. Liver dysfunction was most predictive of mortality on Day 1 in both cohorts (OR 1.3; 95%CI 1.2 - 1.4; OR 1.3; 95%CI 1.2 - 1.4, respectively). In the eICU-CRD cohort, central nervous system dysfunction was most predictive of mortality on Day 7 (OR 1.4; 95%CI 1.4 - 1.5). In the MIMIC-IV cohort, respiratory dysfunction (OR 1.4; 95%CI 1.3 - 1.5) and cardiovascular dysfunction (OR 1.4; 95%CI 1.3 - 1.5) were most predictive of mortality on Day 7.
Conclusion:
The SOFA score may be an oversimplification of how dysfunction of different organ systems contributes to mortality over time. Further research at a more granular timescale is needed to explore how the SOFA score can evolve and be ameliorated.
Keywords:Central nervous systemsHospitalsintensive care unitsLiverLogistic modelsmortalityOrgan dysfunction scoresPatient dischargeSee moreViews131
Abstract
Original ArticleAnalyzing how the components of the SOFA score change over time in their contribution to mortality
Critical Care Science. 2024;36:e20240030en
DOI 10.62675/2965-2774.20240030-en
- Barbara D. Lam ,
- Tristan Struja ,
- Yanran Li ,
- João Matos ,
- Ziyue Chen ,
- Xiaoli Liu ,
- Leo Anthony Celi ,
- Yugang Jia ,
- Jesse Raffa
Views131ABSTRACT
Objective:
Determine how each organ component of the SOFA score differs in its contribution to mortality risk and how that contribution may change over time.
Methods:
We performed multivariate logistic regression analysis to assess the contribution of each organ component to mortality risk on Days 1 and 7 of an intensive care unit stay. We used data from two publicly available datasets, eICU Collaborative Research Database (eICU-CRD) (208 hospitals) and Medical Information Mart for Intensive Care IV (MIMIC-IV) (1 hospital). The odds ratio of each SOFA component that contributed to mortality was calculated. Mortality was defined as death either in the intensive care unit or within 72 hours of discharge from the intensive care unit.
Results:
A total of 7,871 intensive care unit stays from eICU-CRD and 4,926 intensive care unit stays from MIMIC-IV were included. Liver dysfunction was most predictive of mortality on Day 1 in both cohorts (OR 1.3; 95%CI 1.2 - 1.4; OR 1.3; 95%CI 1.2 - 1.4, respectively). In the eICU-CRD cohort, central nervous system dysfunction was most predictive of mortality on Day 7 (OR 1.4; 95%CI 1.4 - 1.5). In the MIMIC-IV cohort, respiratory dysfunction (OR 1.4; 95%CI 1.3 - 1.5) and cardiovascular dysfunction (OR 1.4; 95%CI 1.3 - 1.5) were most predictive of mortality on Day 7.
Conclusion:
The SOFA score may be an oversimplification of how dysfunction of different organ systems contributes to mortality over time. Further research at a more granular timescale is needed to explore how the SOFA score can evolve and be ameliorated.
Keywords:Central nervous systemsHospitalsintensive care unitsLiverLogistic modelsmortalityOrgan dysfunction scoresPatient dischargeSee more
- Barbara D. Lam
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Original Article01-24-2021
Correlation between syndecan-1 level and PELOD-2 score and mortality in pediatric sepsis
Revista Brasileira de Terapia Intensiva. 2021;33(4):549-556
Abstract
Original ArticleCorrelation between syndecan-1 level and PELOD-2 score and mortality in pediatric sepsis
Revista Brasileira de Terapia Intensiva. 2021;33(4):549-556
DOI 10.5935/0103-507X.20210083
Views73See moreABSTRACT
Objective:
To analyze the correlation between glycocalyx disruption measured via the serum syndecan-1 level and organ dysfunctions assessed by the PELOD-2 score and to evaluate its association with mortality in pediatric sepsis.
Methods:
We performed a prospective observational study in a tertiary public hospital. Sixty-eight pediatric patients diagnosed with sepsis according to International Pediatric Sepsis Consensus Conference criteria were consecutively recruited. We performed measurements of day 1 and day 5 serum syndecan-1 levels and PELOD-2 score components. Patients were followed up to 28 days following sepsis diagnosis.
Results:
Overall, the syndecan-1 level was increased in all subjects, with a significantly higher level among septic shock patients (p = 0.01). The day 1 syndecan-1 level was positively correlated with the day 1 PELOD-2 score with a correlation coefficient of 0.35 (p = 0.003). Changes in syndecan-1 were positively correlated with changes in the PELOD-2 score, with a correlation coefficient of 0.499 (p < 0.001) during the first five days. Using the cutoff point of day 1 syndecan-1 ≥ 430ng/mL, organ dysfunction (PELOD-2 score of ≥ 8) could be predicted with an AUC of 74.3%, sensitivity of 78.6%, and specificity of 68.5% (p = 0.001).
Conclusion:
The day 1 syndecan-1 level was correlated with the day 1 PELOD-2 score but not 28-day mortality. Organ dysfunction (PELOD-2 ≥ 8) could be predicted by the syndecan-1 level in the first 24 hours of sepsis, suggesting its significant pathophysiological involvement in sepsis-associated organ dysfunction.
Views73Abstract
Original ArticleCorrelation between syndecan-1 level and PELOD-2 score and mortality in pediatric sepsis
Revista Brasileira de Terapia Intensiva. 2021;33(4):549-556
DOI 10.5935/0103-507X.20210083
Views73See moreABSTRACT
Objective:
To analyze the correlation between glycocalyx disruption measured via the serum syndecan-1 level and organ dysfunctions assessed by the PELOD-2 score and to evaluate its association with mortality in pediatric sepsis.
Methods:
We performed a prospective observational study in a tertiary public hospital. Sixty-eight pediatric patients diagnosed with sepsis according to International Pediatric Sepsis Consensus Conference criteria were consecutively recruited. We performed measurements of day 1 and day 5 serum syndecan-1 levels and PELOD-2 score components. Patients were followed up to 28 days following sepsis diagnosis.
Results:
Overall, the syndecan-1 level was increased in all subjects, with a significantly higher level among septic shock patients (p = 0.01). The day 1 syndecan-1 level was positively correlated with the day 1 PELOD-2 score with a correlation coefficient of 0.35 (p = 0.003). Changes in syndecan-1 were positively correlated with changes in the PELOD-2 score, with a correlation coefficient of 0.499 (p < 0.001) during the first five days. Using the cutoff point of day 1 syndecan-1 ≥ 430ng/mL, organ dysfunction (PELOD-2 score of ≥ 8) could be predicted with an AUC of 74.3%, sensitivity of 78.6%, and specificity of 68.5% (p = 0.001).
Conclusion:
The day 1 syndecan-1 level was correlated with the day 1 PELOD-2 score but not 28-day mortality. Organ dysfunction (PELOD-2 ≥ 8) could be predicted by the syndecan-1 level in the first 24 hours of sepsis, suggesting its significant pathophysiological involvement in sepsis-associated organ dysfunction.
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Original Article03-01-2018
SOFA in the first 24 hours as an outcome predictor of acute liver failure
Revista Brasileira de Terapia Intensiva. 2018;30(1):64-70
Abstract
Original ArticleSOFA in the first 24 hours as an outcome predictor of acute liver failure
Revista Brasileira de Terapia Intensiva. 2018;30(1):64-70
DOI 10.5935/0103-507X.20180012
Views71See moreABSTRACT
Objective:
To describe a cohort of patients with acute liver failure and to analyze the demographic and clinical factors associated with mortality.
Methods:
Retrospective cohort study in which all patients admitted for acute liver failure from July 28, 2012, to August 31, 2017, were included. Clinical and demographic data were collected using the Epimed System. The SAPS 3, SOFA, and MELD scores were measured. The odds ratios and 95% confidence intervals were estimated. Receiver operating characteristics curves were obtained for the prognostic scores, along with the Kaplan-Meier survival curve for the score best predicting mortality.
Results:
The majority of the 40 patients were female (77.5%), and the most frequent etiology was hepatitis B (n = 13). Only 35% of the patients underwent liver transplantation. The in-hospital mortality rate was 57.5% (95%CI: 41.5 - 73.5). Among the scores investigated, only SOFA remained associated with risk of death (OR = 1.37; 95%CI 1.11 - 1.69; p < 0.001). After SOFA stratification into < 12 and ≥ 12 points, survival was higher in patients with SOFA <12 (log-rank p < 0.001).
Conclusion:
SOFA score in the first 24 hours was the best predictor of fatal outcome.
Views71Abstract
Original ArticleSOFA in the first 24 hours as an outcome predictor of acute liver failure
Revista Brasileira de Terapia Intensiva. 2018;30(1):64-70
DOI 10.5935/0103-507X.20180012
Views71See moreABSTRACT
Objective:
To describe a cohort of patients with acute liver failure and to analyze the demographic and clinical factors associated with mortality.
Methods:
Retrospective cohort study in which all patients admitted for acute liver failure from July 28, 2012, to August 31, 2017, were included. Clinical and demographic data were collected using the Epimed System. The SAPS 3, SOFA, and MELD scores were measured. The odds ratios and 95% confidence intervals were estimated. Receiver operating characteristics curves were obtained for the prognostic scores, along with the Kaplan-Meier survival curve for the score best predicting mortality.
Results:
The majority of the 40 patients were female (77.5%), and the most frequent etiology was hepatitis B (n = 13). Only 35% of the patients underwent liver transplantation. The in-hospital mortality rate was 57.5% (95%CI: 41.5 - 73.5). Among the scores investigated, only SOFA remained associated with risk of death (OR = 1.37; 95%CI 1.11 - 1.69; p < 0.001). After SOFA stratification into < 12 and ≥ 12 points, survival was higher in patients with SOFA <12 (log-rank p < 0.001).
Conclusion:
SOFA score in the first 24 hours was the best predictor of fatal outcome.
Organ dysfunction scores Archives - Critical Care Science (CCS)
