Elias et al developed an Acute Organ Failure Score (AOFS) for evaluating a critically-ill adult. This can help to identify a patient who may benefit from more aggressive management. The authors are from Brigham and Women's Hospital, Okinawa Hokubu Prefectural Hospital, and Massachusetts General Hospital.
Patient: critically-ill adult
Outcome: 30-day mortality
Parameters:
(1) age of the patient in years
(2) Dayo-Charlson comorbidity index
(3) patient type
(4) race
(5) sepsis
(6) respiratory organ failure
(7) renal organ failure
(8) hepatic organ failure
(9) hematologic organ failure
(10) metabolic organ failure
(11) neurologic organ failure
Parameter
Finding
Points
age in years
< 45 years
0
45 to 54 years
2
55 to 64 years
2
65 to 74 years
3
>= 75 years
5
Dayo-Charlson comoribidity
0 or 1
0
2 or 3
1
4 to 6
2
>= 7
2
patient type
medical
5
surgical
0
race
White
0
non-White
-1
sepsis
no
0
yes
4
respiratory failure
no
0
yes
4
renal failure
no
0
yes
2
hepatic failure
no
0
yes
3
hematologic failure
no
0
yes
1
metabolic failure
no
0
yes
1
neurologic failure
no
0
yes
2
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: -1
• maximum score: 29
• The higher the score the greater the risk of mortality.
Score
Risk Group
30-Day Mortality
<= 5
low
4%
6 to 9
intermediate
6 to 8%
10 to 13
high
13 to 18%
14 to 29
very high
30 to 36%
Performance:
• The area under the ROC curve is approximately 0.74.
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