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. 2024 Nov 22:36:e20240030en.
doi: 10.62675/2965-2774.20240030-en. eCollection 2024.

Analyzing how the components of the SOFA score change over time in their contribution to mortality

[Article in English, Portuguese]
Barbara D Lam  1 , Tristan Struja  2 , Yanran Li  3 , João Matos  2 , Ziyue Chen  4 , Xiaoli Liu  2 , Leo Anthony Celi  1 , Yugang Jia  2 , Jesse Raffa  2
Affiliations

Analyzing how the components of the SOFA score change over time in their contribution to mortality

[Article in English, Portuguese]
Barbara D Lam et al. Crit Care Sci. .

Abstract
in English, Portuguese

Objective: Determine how each organ component of the SOFA score differs in its contribution to mortality risk and how that contribution may change over time.

Methods: We performed multivariate logistic regression analysis to assess the contribution of each organ component to mortality risk on Days 1 and 7 of an intensive care unit stay. We used data from two publicly available datasets, eICU Collaborative Research Database (eICU-CRD) (208 hospitals) and Medical Information Mart for Intensive Care IV (MIMIC-IV) (1 hospital). The odds ratio of each SOFA component that contributed to mortality was calculated. Mortality was defined as death either in the intensive care unit or within 72 hours of discharge from the intensive care unit.

Results: A total of 7,871 intensive care unit stays from eICU-CRD and 4,926 intensive care unit stays from MIMIC-IV were included. Liver dysfunction was most predictive of mortality on Day 1 in both cohorts (OR 1.3; 95%CI 1.2 - 1.4; OR 1.3; 95%CI 1.2 - 1.4, respectively). In the eICU-CRD cohort, central nervous system dysfunction was most predictive of mortality on Day 7 (OR 1.4; 95%CI 1.4 - 1.5). In the MIMIC-IV cohort, respiratory dysfunction (OR 1.4; 95%CI 1.3 - 1.5) and cardiovascular dysfunction (OR 1.4; 95%CI 1.3 - 1.5) were most predictive of mortality on Day 7.

Conclusion: The SOFA score may be an oversimplification of how dysfunction of different organ systems contributes to mortality over time. Further research at a more granular timescale is needed to explore how the SOFA score can evolve and be ameliorated.

Objetivo:: Determinar como cada componente de órgão do escore SOFA difere em sua contribuição no risco de mortalidade e como essa contribuição pode variar ao longo do tempo.

Métodos:: Realizamos uma análise de regressão logística multivariada para avaliar a contribuição de cada componente de órgão no risco de mortalidade no primeiro e sétimo dia de internação em unidade de terapia intensiva. Usamos dados de dois conjuntos de dados públicos, a eICU Collaborative Research Database (eICU-CRD) (208 hospitais) e a Medical Information Mart for Intensive Care IV (MIMIC-IV) (um hospital). Calculamos a razão de chances de cada componente do SOFA, que contribuiu para a mortalidade. A mortalidade foi definida como morte na unidade de terapia intensiva ou dentro de 72 horas após a alta da unidade de terapia intensiva.

Resultados:: Foram incluídas 7.871 internações em unidades de terapia intensiva da eICU-CRD e 4.926 internações em unidades de terapia intensiva da MIMIC-IV. A disfunção hepática foi a mais preditiva de mortalidade no primeiro dia em ambas as coortes (RC 1,3; IC95% 1,2 - 1,4; RC 1,3; IC95% 1,2 - 1,4, respectivamente). Na coorte eICU-CRD, a disfunção do sistema nervoso central foi a mais preditiva de mortalidade no sétimo dia (RC 1,4; IC95% 1,4 - 1,5). Na coorte MIMIC-IV, a disfunção respiratória (RC 1,4; IC95% 1,3 - 1,5) e cardiovascular (RC 1,4; IC95% 1,3 - 1,5) foram mais preditivas de mortalidade no sétimo dia.

Conclusão:: O escore SOFA pode ser uma simplificação exagerada de como a disfunção de diferentes sistemas de órgãos contribui para a mortalidade ao longo do tempo. São necessários mais estudos em uma escala de tempo mais granular para explorar como o escore SOFA pode evoluir e ser aprimorado.

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Conflict of interest statement

Conflicts of interest: Y. Jia is currently employed by Verily Life Sciences. For all the remaining authors, no conflicts of interest are declared.

Figures

Figure 1
Figure 1. Cohort selection from the eICU Collaborative Research Database and Medical Information Mart for Intensive Care IV databases.
Figure 2
Figure 2. Contribution of organ dysfunction to mortality on Days 1 and 7.
Figura 1
Figura 1. Seleção de coorte dos bancos de dados da eICU Collaborative Research Database e do Medical Information Mart for Intensive Care IV.
Figura 2
Figura 2. Contribuição da disfunção orgânica na mortalidade no primeiro e no sétimo dia.
See this image and copyright information in PMC

References

    1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315(8):801–810. - PMC - PubMed
    1. Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction-failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998;26(11):1793–1800. - PubMed
    1. Minne L, Abu-Hanna A, de Jonge E. Evaluation of SOFA-based models for predicting mortality in the ICU: a systematic review. Crit Care. 2008;12(6):R161–R161. - PMC - PubMed
    1. Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754–1758. - PubMed
    1. Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, et al. The use of maximum SOFA score to quantify organ dysfunction-failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis related Problems of the ESICM. Intensive Care Med. 1999;25(7):686–696. - PubMed

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