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Observational Study
. 2025 May 16;104(20):e42464.
doi: 10.1097/MD.0000000000042464.

Value of SOFA score, APACHE II score, and WBC count for mortality risk assessment in septic patients: A retrospective study

Dengkai Li  1 , Yanfang Wei  2 , Chunfang Zhang  1 , Yun Yang  1 , Zhenqiang Wang  2 , Yaru Lu  1 , Lei Liu  1
Affiliations
Observational Study

Value of SOFA score, APACHE II score, and WBC count for mortality risk assessment in septic patients: A retrospective study

Dengkai Li et al. Medicine (Baltimore). .

Abstract

Sepsis is characterized by rapid onset, swift progression, and poor prognosis. Delay in early recognition and treatment may easily escalate to septic shock, resulting in a markedly high mortality rate. Early prognosis assessment holds significant value in enhancing the clinical outcomes of septic patients. The sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation II (APACHE II) score are commonly utilized clinical tools for assessing patients' conditions, while white blood cell (WBC) count is frequently employed to evaluate the inflammatory status of the body. The study aimed to investigate the prognostic value of SOFA score, APACHE II score, and WBC count in assessing the risk of mortality in septic patients, providing valuable insights for improving the prognosis of septic patients. In this retrospective study, 139 patients diagnosed with sepsis in our hospital from January 2021 to December 2023 were selected as the study subjects. Clinical outcomes of the patients were collected through a 28-day follow-up period, and patients were categorized into the survival group (n = 96) and the death group (n = 43). The value of SOFA score, APACHE II score, and WBC count for the mortality risk assessment in septic patients was calculated by plotting ROC curves, and the risk factors for mortality in septic patients were analyzed. The AUC of SOFA score was 0.809 (95% CI = 0.734-0.871, P < .0001) for predicting the mortality risk of sepsis. The AUC of APACHE score was 0.806 (95% CI = 0.729-0.884, P < .0001) for predicting the mortality risk of sepsis. The AUC of WBC count was 0.689 (95% CI = 0.591-0.788, P = .004) for predicting the mortality risk of sepsis. The AUC of combined detection was 0.861 (95% CI = 0.792-0.914, P < .0001) for predicting the mortality risk of sepsis. Univariate analysis revealed that SOFA, APACHE II, and WBC were correlated with mortality in septic patients (P < .05). Patients with sepsis demonstrate significant elevations in WBC count, SOFA, and APACHE II scores. The combined application of these indicators holds considerable value in predicting the mortality outcomes of septic patients. Accordingly, clinical treatment plans can be adjusted based on these aforementioned indicators to ameliorate the prognosis of septic patients.

Keywords: APACHE II score; SOFA score; WBC count; mortality outcome; predictive value; sepsis.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow diagram of the study.
Figure 2.
Figure 2.
Comparison of WBC count, SOFA score, and APACHE II score between the death and survival groups. APACHE II = acute physiology and chronic health evaluation II, SOFA = sequential organ failure assessment, WBC = white blood cell.
Figure 3.
Figure 3.
ROC curve of SOFA score for predicting mortality risk of sepsis. SOFA = sequential organ failure assessment.
Figure 4.
Figure 4.
ROC curve of APACHE II score for predicting mortality risk of sepsis. APACHE II = acute physiology and chronic health evaluation II.
Figure 5.
Figure 5.
ROC curve of WBC count for predicting mortality risk of sepsis. WBC = white blood cell.
Figure 6.
Figure 6.
Analysis of the predictive value of combined detection for mortality risk of sepsis.
Figure 7.
Figure 7.
Logistic regression analysis of prognosis in septic patients.
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