Utility of SOFA (Sequential Organ Function Assessment) score to predict outcome in critically ill patients at a tertiary care hospital, Nagpur

SUMMARY

Prognostication is an important part of management of any critically ill patients. It helps in predicting the reliable outcome of a patients’ current standing. SOFA (Sequential Organ Function Assessment) score is a prognostic scoring system used to track a person’s status during the stay in an intensive care unit. It is based on functions of 6 organ systems-respiratory system, cardiovascular system, Hepatic system, coagulation system, excretory system and nervous system. Although it contains many parameters which are difficult to remember, one can use the readymade calculators present on internet. This study was undertaken with the objective to study the utility of SOFA scores in predicting outcome in critically ill patients. Outcome measures being ICU mortality and length of ICU stay. This prospective observational hospital based longitudinal study was carried out over a period of 2 months in a tertiary care hospital catering more of rural population. Adult critically ill patient irrespective of underlying cause were included in study after taking written consent from patient or his akin. Patient’s demographic profile, the main diagnosis leading to hospitalization in the ICU, previous interventions, complications and hospital outcomes were recorded for each patient. Appropriate investigations were done. SOFA score was calculated in period 0-24 hrs (SOFA 1), 24-48 hrs (SOFA 2) and 48-96 hrs (SOFA 3) from admission to ICU. SOFA scores were correlated with outcome measures ICU mortality and length of ICU stay. The non survivors had high initial, mean and highest SOFA scores as compared to survivors. Initial and highest scores of more than 15 corresponded to mortality of more than 75%. The predictive value of the mean score had negligible relation and therefore was independent of the length of ICU stay. Length of stay is not significant and independent of mortality. Increasing SOFA score in first 48 hrs gives a mortality rate of >50%. The SOFA scoring system is useful in predicting outcomes in ICU. High SOFA scores, and increasing trend in SOFA scores were found to be significantly associated with mortality and length of ICU stay.Keywords: ICU stay, SOFA score, Tertiary care hospital.