Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients
10.3346/jkms.2023.38.e418
- Author:
Byuk Sung KO
1
;
Seung Mok RYOO
;
Eunah HAN
;
Hyunglan CHANG
;
Chang June YUNE
;
Hui Jai LEE
;
Gil Joon SUH
;
Sung-Hyuk CHOI
;
Sung Phil CHUNG
;
Tae Ho LIM
;
Won Young KIM
;
Jang Won SOHN
;
Mi Ae JEONG
;
Sung Yeon HWANG
;
Tae Gun SHIN
;
Kyuseok KIM
;
On behalf of Korean Shock Society
Author Information
1. Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2023;38(50):e418-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:There is a need to update the cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score to reflect the current practice in sepsis. We previously proposed the modified CV SOFA score from data on blood pressure, norepinephrine equivalent dose, and lactate as gathered from emergency departments. In this study, we externally validated the modified CV SOFA score in multicenter intensive care unit (ICU) patients.
Methods:A multicenter retrospective observational study was conducted on ICU patients at six hospitals in Korea. We included adult patients with sepsis who were admitted to ICUs. We compared the prognostic performance of the modified CV/total SOFA score and the original CV/total SOFA score in predicting 28-day mortality. Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and the calibration curve, respectively.
Results:We analyzed 1,015 ICU patients with sepsis. In overall patients, the 28-day mortality rate was 31.2%. The predictive validity of the modified CV SOFA (AUROC, 0.712; 95% confidence interval [CI], 0.677–0.746; P < 0.001) was significantly higher than that of the original CV SOFA (AUROC, 0.644; 95% CI, 0.611–0.677). The predictive validity of modified total SOFA score for 28-day mortality was significantly higher than that of the original total SOFA (AUROC, 0.747 vs. 0.730; 95% CI, 0.715–0.779; P = 0.002). The calibration curve of the original CV SOFA for 28-day mortality showed poor calibration. In contrast, the calibration curve of the modified CV SOFA for 28-day mortality showed good calibration.
Conclusion:In patients with sepsis in the ICU, the modified SOFA score performed better than the original SOFA score in predicting 28-day mortality.
