SOFA Score Plus Lactate (SOFA-L) of Froehlich et al

Description

Froehlich et al modified the SOFA (Sepsis-related Organ Failure Assessment) score by adding points for blood lactate concentrations. This can be helpful in evaluating a patient with alcoholic liver disease in the intensive care unit (ICU). The authors are from St. Vincent's University Hospital and University College Dublin in Ireland.

Patient selection: alcoholic liver disease in the ICU

Outcome: in-hospital mortality

Parameters:

(1) SOFA score (range 0 to 24)

(2) blood lactate in mEq/L (mmol/L)

Blood Lactate	Points
<= 3	0
3.01 to 6.0	2
6.01 to 9	4
9.01 to 12	6
> 12	8

where:

• The table shows overlap at 3, 6, and 9 mEq/L

SOFAL score =

= (points for SOFA) + (points for lactate)

Interpretation:

• minimum score: 0

• maximum score: 32

• The higher the score the greater the mortality.

SOFAL vs Mortality	Day 1	Day 3
0 to 9	0%	10%
10 to 12	30%	10%
13 to 15	99%	75%
16 to 18	88%	80%
19 to 32	96%	99%

estimated from Figure 3.

Performance:

• The area under the ROC curve was 0.92 on Day 1 and 0.93 on Day 3.

• A SOFA-L on day 1 > 12 was 85% sensitive and 91% specific.

• A SOFA-L on day 3 > 12 was 93% sensitive and 85% specific.

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Description

Specialty

ICD-10