Grissom et al reported a modified Sequential Organ Failure Assessment (MSOFA) score for use in a resource-constrained setting. The authors are from Intermountain Medical Center and the University of Utah at Salt Lake City.
Parameters:
(1) SpO2 to FIO2 ratio (as measure of respiratory function)
(2) jaundice or scleral icterus (as measure of liver function)
(3) hypotension (as measure of cardiovascular function)
(4) Glasgow coma score (as measure of neurologic status)
(5) serum creatinine in mg/dL (as measure of renal function)
|
Parameter |
Finding |
Points |
|
SpO2 to FIO2 ratio |
> 400 |
0 |
|
|
316 to 400 |
1 |
|
|
236 to 315 |
2 |
|
|
151 to 235 |
3 |
|
|
<= 150 |
4 |
|
jaundice or scleral icterus |
absent |
0 |
|
|
present |
3 |
|
hypotension |
none |
0 |
|
|
mean arterial pressure < 70 |
1 |
|
|
any dose dobutamine |
2 |
|
|
dopamine <= 5 µg/kg/min |
2 |
|
|
dopamine 5.1-15.0 µg/kg/min |
3 |
|
|
dopamine > 15 µg/kg/min |
4 |
|
|
epinephrine <= 0.1 µg/kg/min |
3 |
|
|
epinephrine > 0.1 µg/kg/min |
4 |
|
|
norepinephrine <= 0.1 µg/kg/min |
3 |
|
|
norepinephrine > 0.1 µg/kg/min |
4 |
|
Glasgow Coma Scale |
15 |
0 |
|
|
13 or 14 |
1 |
|
|
10 to 12 |
2 |
|
|
6 to 9 |
3 |
|
|
3 to 5 |
4 |
|
serum creatinine |
< 1.2 |
0 |
|
|
1.2 to 1.9 |
1 |
|
|
2.0 to 3.4 |
2 |
|
|
3.5 to 4.9 |
3 |
|
|
>= 5.0 |
4 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the worse the prognosis.
|
Day 1 MSOFA |
Mortality |
|
0 to 7 |
4.5% |
|
8 to 11 |
31% |
|
12 to 20 |
58% |
Performance:
• The area under the ROC curve for day 1 prediction of mortality was 0.84.
• The area under the ROC curve for day 3 prediction of mortality was 0.79.
Specialty: Critical Care, Infectious Diseases
