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The Sequential Organ Failure Assessment (SOFA) score: a useful prognostic instrument after cardiac surgery for the elderly patient
BMC Geriatrics volume 10, Article number: A99 (2010)
Organ dysfunction evaluation using Sequential Organ Failure Assessment score (SOFA score) has been shown to predict mortality and morbidity in adult cardiac surgical patients .
Materials and methods
Design: analysis of a prospectively collected database.
Setting: mixed Intensive Care Unit (ICU) in an University Hospital.
Patients: A total of 70 patients (ASA II-IV) aged >65 submitted to cardiac surgery. They were evaluated on 24,48 and 72 hours after ICU admission. All post-operative ASA IV-E (E= emergency) and all ICU patients with different diagnosis were excluded from data collection.
Interventions: the collection of raw data necessary for the computation of a SOFA score on 24, 48 and 72 hours after admission and basic demographic and clinical statistics.
Data collection: We collected the parameters in order to calculate the Admission (AD), Daily, Mean, Total Maximum (TM) and Delta (Δ) SOFA score at the specific time points mentioned above.
The Admission, TMS score and Δ SOFA presented a good correlation with mortality [area under the curve 0,9 (SE 0,060) and 0,809 (SE 0,136), respectively]. All the patients that receive more than 2000 ml of intraoperative fluids had an Admission SOFA Score between 16 and 20 (p<0.001). All the patients with preoperative Left Ventricular Ejection Fraction > 45% had an Admission SOFA Score between 2 and 10 (p<0.001). All the patients mechanically ventilated for more than 5 days presented an Admission SOFA score between 17 and 20, while the same score was between 0 and 10 for those successfully extubated after 24 hours (p<0.001). The mean cardiovascular, coagulation, hepatic, neurological and renal SOFA score were associated with the highest relative contribution to outcome [area under the curve 0,980 (SE 0,028), 0,951 (SE 0,057), 0,927 (SE 0,069), 0,991 (SE 0,019) and 0,944 (SE 0,061), respectively].
SOFA score is a useful prognostic instrument even in this specific clinical context.
Pätilä T, Kukkonen S, Vento A, Pettilä V, Suojaranta-Ylinen R: Relation of the Sequential Organ Failure Assessment score to morbidity and mortality after cardiac surgery. Ann Thorac Surg. 2006, 82 (6): 2072-8. 10.1016/j.athoracsur.2006.06.025.
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Caroleo, S., Onorati, F., Bruno, O. et al. The Sequential Organ Failure Assessment (SOFA) score: a useful prognostic instrument after cardiac surgery for the elderly patient. BMC Geriatr 10, A99 (2010) doi:10.1186/1471-2318-10-S1-A99
- Intensive Care Unit
- Organ Dysfunction
- Intensive Care Unit Admission
- Intensive Care Unit Patient
- Sequential Organ Failure Assessment