What every intensivist should know about prognostic scoring systems and risk-adjusted mortality - Critical Care Science (CCS)

Sequential Organ Failure Assessment: an organ dysfunction score

Multiple organ dysfunction syndrome is a major cause of ICU morbidity and mortality. The extent and severity of organ dysfunction may be quantified in a number of organ dysfunction scores, the most prominent of which is the SOFA.⁽⁾ Originally designed to be used in patients with sepsis, the SOFA is now used in all patient groups. Daily scores can be calculated and used to track the degree of organ dysfunction throughout a patient’s ICU stay – in contrast to generic prognostic systems, which are designed to give a prediction based on the first ICU day alone. Scores between 0 and 4 are assigned to each of the cardiovascular, respiratory, hepatic, hematologic, neurologic and renal systems, depending on the degree of derangement, and are summed to yield a total SOFA score. Such scores were not originally designed to predict mortality, but high absolute scores and an increase in a score within the first 96 hours of ICU care are associated with increased risk of death.⁽⁾

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