Consideration of additional factors in Sequential Organ Failure Assessment score.

Abstract

PURPOSE: The Sequential Organ Failure Assessment (SOFA) score, originally

developed to assess organ failure status, is widely used as a prognostic

indicator in intensive care unit patients. Additional prognostic factors, such as

age and comorbidities, may complement the predictive performance of the SOFA.

METHODS: In total, 1049 consecutive patients were enrolled prospectively. SOFA

and other admission-based intensive care unit scores were recorded during the

first 24 hours. A complemented SOFA (cSOFA) score model was constructed by adding

age and comorbidity scores to the original SOFA score, based on logistic

regression analysis. The predictive performance was evaluated with regard to

hospital mortality by receiver operating characteristics analysis. The

Hosmer-Lemeshow goodness-of-fit test was used to assess calibration of the model,

and leave-one-out cross-validation was performed. RESULTS: The cSOFA score

(maximum 30 points) was calculated as the SOFA score (24 points) + age score (2

points) + comorbidity score (4 points). The cSOFA score model showed satisfactory

calibration and cross-validation performance. The AUC (95% CI) of the cSOFA score

(0.812 [0.787-0.835]) was higher than the SOFA score (0.743 [0.715-0.769], P <

.0001). CONCLUSION: The performance of the SOFA score to predict hospital

mortality can be improved by considering age and comorbidity factors.