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Delta SOFA Score Day 7 and 28-Day Mortality for a Patient with Sepsis

Description

Karkike et al used changes in the SOFA score to predict outcomes for a patient with sepsis. The change in the SOFA between the first and seventh day can help to identify a patient who may need more aggressive management. The authors are from Attikon University Hospital, National and Kapodistrian University of Athens and Universite libre de Bruxelles in Brussels.


Patient selection: sepsis by the Sepsis-3 definition

 

Parameters:

(1) SOFA on day 1 (initial SOFA)

(2) SOFA on day 7

 

delta SOFA =

= (SOFA day 1) - (SOFA day 7)

 

delta SOFA as percent of day 1 SOFA =

= (delta SOFA) / (SOFA day 1) * 100%

 

Interpretation:

• A delta SOFA on day 7 < 25% is associated with increased 28-day mortality (OR 14.9).

• When the delta SOFA was >= 25% the 28-day mortality was 7.3% vs 54.1% when it was < 25%.

• A delta SOFA on day 7 < 25% is associated with increased 90-day mortality (OR 13.2).

 

Performance:

• The area under the ROC curve for 28-day mortality was 0.84.

• The initial SOFA was in the range of 6 to 7. A very low SOFA score might not change much so there may be a minimum SOFA that needs to be exceeded for best performance.


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