Namendy-Silva et al reported a modified SOFA score for use in Mexico. This uses the SpO2 to FIO2 ratio rather than PaO2 to FIO2 ratio. The authors are from Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran and Instituto Nacional de Cancerologia in Mexico City.
Patient selection: ICU patient > 16 years (not limited to sepsis)
If more than one value is available on a particular day, then the "worst" value is used.
Parameters:
(1) cardiovascular function (based on mean arterial pressure or need for vasopressors)
(2) respiratory (based on SpO2 to FIO2 ratio, mechanical ventilation and PEEP)
(3) platelet count per µL (as measure of coagulation)
(4) total serum bilirubin in mg/dL (as measure of hepatic function)
(5) serum creatinine in mg/dLor urine output in mL per day as measures of renal function
|
Parameter |
Finding |
Points |
|
cardiovascular |
mean arterial pressure (MAP) >= 70 mm Hg |
0 |
|
|
MAP < 70 mm Hg |
1 |
|
|
dopamine <= 5 µg/kg/min OR dobutamine any dose, for at least 1 hour |
2 |
|
|
dopamine 5.1 to 15 5 µg/kg/min OR norepinephrine <= 0.15 µg/kg/min |
3 |
|
|
dopamine > 15 5 µg/kg/min OR norepinephrine > 0.1 µg/kg/min |
4 |
|
SpO2 to FIO2 ratio without PEEP or mechanical ventilation |
>= 512 |
0 |
|
|
357 to 511.9 |
1 |
|
|
214 to 356.9 |
2 |
|
|
89 to 213.9 |
3 |
|
|
< 89 |
4 |
|
SpO2 to FIO2 ratio with PEEP AND mechanical ventilation (MV) |
see below |
see below |
|
platelet count |
>= 150,000 per µL |
0 |
|
|
100,000 to 149,999 |
1 |
|
|
50,000 to 99,999 |
2 |
|
|
20,000 to 49,999 |
3 |
|
|
< 20,000 per µL |
4 |
|
total serum bilirubin |
< 1.2 mg/dL |
0 |
|
|
1.2 to 1.9 mg/dL |
1 |
|
|
2.0 to 5.9 mg/dL |
2 |
|
|
6.0 to 11.9 mg/dL |
3 |
|
|
>= 12 mg/dL |
4 |
|
serum creatinine or urine output |
< 1.2 mg/dL |
0 |
|
|
1.2 to 1.9 mg/dL |
1 |
|
|
2.0 to 3.4 mg/dL |
2 |
|
|
3.5 to 4.9 mg/dL OR 200 to 499 mL urine per day |
3 |
|
|
>= 5.0 mg/dL OR < 200 mL urine per day |
4 |
|
SpO2 to FIO2 Ratio |
Points |
|
|
< 8 |
>= 502 |
0 |
|
|
370 to 501.9 |
1 |
|
|
240 to 369.9 |
2 |
|
|
115 to 239.9 |
3 |
|
|
< 115 |
4 |
|
8 to 12 |
>= 515 |
0 |
|
|
387 to 514.9 |
1 |
|
|
259 to 386.9 |
2 |
|
|
130 to 258.9 |
3 |
|
|
< 130 |
4 |
|
> 12 |
>= 425 |
0 |
|
|
332 to 424.9 |
1 |
|
|
234 to 331.9 |
2 |
|
|
129 to 233.9 |
3 |
|
|
< 129 |
4 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the more severe the patient's condition and the greater the mortality.
• Scores can be recorded on admission and at 48 hours.
• A delta score is the score at 48 hours minus score on admission.
Performance:
• The area under the ROC curve was 0.73.
Specialty: Critical Care, Infectious Diseases
