Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May 20;14(5):e0216177.
doi: 10.1371/journal.pone.0216177. eCollection 2019.

Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit

Jacob C Jentzer  1   2 , Courtney Bennett  1   2 , Brandon M Wiley  1   2 , Dennis H Murphree  3 , Mark T Keegan  4 , Gregory W Barsness  1
Affiliations

Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit

Jacob C Jentzer et al. PLoS One. .

Abstract

Purpose: To determine the impact of Sequential Organ Failure Assessment (SOFA) organ sub-scores for hospital mortality risk stratification in a contemporary cardiac intensive care unit (CICU) population.

Materials and methods: Adult CICU admissions between January 1, 2007 and December 31, 2015 were reviewed. The SOFA score and organ sub-scores were calculated on CICU day 1; patients with missing SOFA sub-score data were excluded. Discrimination for hospital mortality was assessed using area under the receiver-operator characteristic curve (AUROC) values, followed by multivariable logistic regression.

Results: We included 1214 patients with complete SOFA sub-score data. The mean age was 67 ± 16 years (38% female); all-cause hospital mortality was 26%. Day 1 SOFA score predicted hospital mortality with an AUROC of 0.72. Each SOFA organ sub-score predicted hospital mortality (all p <0.01), with AUROC values of 0.53 to 0.67. On multivariable analysis, only the cardiovascular, central nervous system, renal and respiratory SOFA sub-scores were associated with hospital mortality (all p <0.01). A simplified SOFA score containing the cardiovascular, central nervous system and renal sub-scores had an AUROC of 0.72.

Conclusions: In CICU patients with complete SOFA sub-score data, risk stratification for hospital mortality is determined primarily by the cardiovascular, central nervous system, renal and respiratory SOFA sub-scores.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Short-term mortality as a function of Day 1 SOFA score in the final study population.
P <0.001 for trend.
Fig 2
Fig 2. Distribution of individual SOFA organ sub-scores in final study population.
See this image and copyright information in PMC

References

    1. Killip T 3rd, Kimball JT: Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol 1967, 20(4):457–464. - PubMed
    1. Katz JN, Shah BR, Volz EM, Horton JR, Shaw LK, Newby LK, et al.: Evolution of the coronary care unit: clinical characteristics and temporal trends in healthcare delivery and outcomes. Crit Care Med 2010, 38(2):375–381. 10.1097/CCM.0b013e3181cb0a63 - DOI - PubMed
    1. Katz JN, Minder M, Olenchock B, Price S, Goldfarb M, Washam JB, et al.: The Genesis, Maturation, and Future of Critical Care Cardiology. J Am Coll Cardiol 2016, 68(1):67–79. 10.1016/j.jacc.2016.04.036 - DOI - PubMed
    1. Morrow DA, Fang JC, Fintel DJ, Granger CB, Katz JN, Kushner FG, et al.: Evolution of critical care cardiology: transformation of the cardiovascular intensive care unit and the emerging need for new medical staffing and training models: a scientific statement from the American Heart Association. Circulation 2012, 126(11):1408–1428. 10.1161/CIR.0b013e31826890b0 - DOI - PubMed
    1. Casella G, Cassin M, Chiarella F, Chinaglia A, Conte MR, Fradella G, et al.: Epidemiology and patterns of care of patients admitted to Italian Intensive Cardiac Care units: the BLITZ-3 registry. J Cardiovasc Med (Hagerstown) 2010, 11(6):450–461. - PubMed