Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit.

• Main Authors: Jacob C Jentzer, Courtney Bennett, Brandon M Wiley, Dennis H Murphree, Mark T Keegan, Gregory W Barsness
• Format: Article
• Language: English
• Published: Public Library of Science (PLoS) 2019-01-01
• Series: PLoS ONE
• Online Access: https://doi.org/10.1371/journal.pone.0216177

<h4>Purpose</h4>To determine the impact of Sequential Organ Failure Assessment (SOFA) organ sub-scores for hospital mortality risk stratification in a contemporary cardiac intensive care unit (CICU) population.<h4>Materials and methods</h4>Adult CICU admissions between January 1, 2007 and December 31, 2015 were reviewed. The SOFA score and organ sub-scores were calculated on CICU day 1; patients with missing SOFA sub-score data were excluded. Discrimination for hospital mortality was assessed using area under the receiver-operator characteristic curve (AUROC) values, followed by multivariable logistic regression.<h4>Results</h4>We included 1214 patients with complete SOFA sub-score data. The mean age was 67 ± 16 years (38% female); all-cause hospital mortality was 26%. Day 1 SOFA score predicted hospital mortality with an AUROC of 0.72. Each SOFA organ sub-score predicted hospital mortality (all p <0.01), with AUROC values of 0.53 to 0.67. On multivariable analysis, only the cardiovascular, central nervous system, renal and respiratory SOFA sub-scores were associated with hospital mortality (all p <0.01). A simplified SOFA score containing the cardiovascular, central nervous system and renal sub-scores had an AUROC of 0.72.<h4>Conclusions</h4>In CICU patients with complete SOFA sub-score data, risk stratification for hospital mortality is determined primarily by the cardiovascular, central nervous system, renal and respiratory SOFA sub-scores.