Accuracy of SOFA Score in Predicting Outcome in Medical Patients with Various Diagnosis in Intensive Care Unit in a Tertiary Care Hospital in Northern India
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: The objective was to assess the accuracy of sequential organ failure assessment (SOFA) score in predicting outcome of patients in Intensive Care Unit (ICU) with various admitting diagnosis. Material and Methods: One hundred ninety consecutive patients between 16 and 90 years admitted to ICU over one year were studied prospectively. Ten patients with incomplete records were excluded. SOFA score was determined on admission to ICU. The mean SOFA scores for each admitting diagnosis was calculated and correlated with mortality in ICU. Results: The mortality rate was 45.3% and the mean duration of stay in the ICU was 9 days. Our study patient cohort was sicker as these were medical patients and evidenced by significantly higher mean SOFA score of 5.50 ± 1.89 in survivors and 11.67 ± 2.87 in non-survivors. The average duration of ICU stay in survivors was 12.14 ± 2.52 days and in non-survivors 5.709 ± 6.16 days. The initial SOFA score had a strong statistical correlation with mortality (P value <0.05) in patients admitted with sepsis, COPD, Community acquired pneumonia and cardiac causes. In patients with AIDP (Acute Inflammatory Demyelinating Polyneuropathy) and ARDS (Acute Respiratory Distress Syndrome), SOFA ≤6 was associated with better outcome. However, in patients admitted with GTCS (Generalised Tonic Clonic seizures) and strokes, SOFA score could not be used to predict outcome (P value >0.05). SOFA score of 0-6 had 0% mortality, 6-9 had 25%, 9-15 had 85% and >15 had 100% mortality. Conclusion: In resource restricted ICUs especially with staff shortage, SOFA score is a simple and effective tool in predicting outcome in patients admitted with medical causes. However, it should always be used in conjunction with clinical judgement especially in patients admitted with stroke and seizures. With increasing number of elderly population, SOFA score may be used in explaining prognosis and counselling relatives in deciding escalation of treatment and do not attempt resuscitation (DNAR). More research is required in assessing the role of SOFA score in various admitting diagnosis.
Authors and Affiliations
Afshan Shabir, Muzaffar Maqbool
Keywords
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