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. 2016 Sep;25(5):409-17.
doi: 10.4037/ajcc2016281.

Sequential Organ Failure Assessment Score Modified for Recent Infection in Patients With Hematologic Malignant Tumors and Severe Sepsis

Jared A Greenberg  1 , Michael Z David  2 , Matthew M Churpek  2 , David L Pitrak  2 , Jesse B Hall  2 , John P Kress  2
Affiliations

Sequential Organ Failure Assessment Score Modified for Recent Infection in Patients With Hematologic Malignant Tumors and Severe Sepsis

Jared A Greenberg et al. Am J Crit Care. 2016 Sep.

Abstract

Background: Baseline health status influences outcomes of severe sepsis.

Objective: To determine if recent infection is a marker of poor health in patients with hematologic malignant tumors and severe sepsis by modifying the Sequential Organ Failure Assessment (SOFA) score to account for infection.

Methods: Medical records of the first 50 patients with hematologic malignant tumors and severe sepsis admitted from September 1, 2009 to September 1, 2014, were reviewed to derive a modified SOFA score. The predictive accuracy of the modified score was compared with that of the unmodified score and the Acute Physiology and Chronic Health Evaluation (APACHE) II score for the 196 subsequent patients.

Results: The area under the receiver operator characteristic curve was 0.73 (95% CI, 0.66-0.80) for the modified score, 0.68 (95% CI, 0.61-0.76) for the unmodified score, and 0.65 (95% CI, 0.58-0.73) for the APACHE II score. The modified score was better for discriminating survivors from nonsurvivors than the unmodified score (P = .005) and the APACHE II score (P = .04). After adjustments for the modified score and age, only increased days from hospital to intensive care unit admission was significantly associated with 30-day mortality.

Conclusion: Modifying the SOFA score to account for infections before admission to the intensive care unit improved the prognostic usefulness of the scores for patients with hematologic malignant tumors and severe sepsis.

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Conflict of interest statement

No other authors have conflicts of interest that could lead to bias.

Figures

Figure 1
Figure 1
Calibration curves for the SOFA-HM, SOFA, and APACHE II scores for the 196 patients in the validation cohort. (Solid line – mean observed mortality. Dashed line – expected mortality)
Figure 2
Figure 2
Receiver Operating Characteristic (ROC) curves for the SOFA-HM, SOFA, and APACHE II scores for the 196 patients in the validation cohort.
See this image and copyright information in PMC

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References

    1. Gaieski DF, Edwards JM, Kallan MJ, Carr BG. Benchmarking the incidence and mortality of severe sepsis in the United States. Critical care medicine. 2013;41(5):1167–1174. - PubMed
    1. Greenberg JA, David MZ, Pitrak DL, Hall JB, Kress JP. Prior infections are associated with increased mortality from subsequent blood-stream infections among patients with hematological malignancies. European journal of clinical microbiology & infectious diseases: official publication of the European Society of Clinical Microbiology. 2014 - PubMed
    1. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101(6):1644–1655. - PubMed
    1. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive care medicine. 1996;22(7):707–710. - PubMed
    1. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. American journal of infection control. 2008;36(5):309–332. - PubMed

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