A new SOFA score calculation to improve the predictive performance for mortality in sepsis-associated disseminated intravascular coagulopathy patients.

PURPOSE: The change in the sequential organ failure assessment (SOFA) score from the entry day, a delta-SOFA (SOFAΔ), has been proposed as a better indicator for predicting mortality, and potentially as an endpoint in clinical trials. However, there are some concerns that the value of the absolute SOFA score has not been considered. The purpose of the study is to examine whether the addition of an absolute SOFA score can increase the predictive performance of SOFAΔ. MATERIALS AND METHODS: Data obtained from 297 patients with sepsis-associated disseminated intravascular coagulopathy (DIC) in multiinstitutional post-marketing surveys were analyzed retrospectively. The SOFAComb (SOFAΔ score + absolute SOFA score) and SOFAΔ were calculated, and the performance of each indicator was analyzed in terms of predictive ability for 28-day mortality. RESULTS: The area under the receiver operating curve (AUC) for the mortality of SOFAComb on day 2, 4, 7 were significantly greater compared to those of SOFAΔ (P <0.001, =0.002, <0.001, respectively). In addition, the accuracy [(True positive + True negative) / total number at the best cutoff points] of SOFAComb was better than that of SOFAΔ. CONCLUSIONS: SOFAComb is simple to calculate and provides better predictive performance compared to SOFAΔ for predicting mortality.

Duke Scholars

Author Jerrold Henry Levy Anesthesiology, Cardiothoracic