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Abstract
Purpose
To determine the usefulness of the Sequential Organ Failure Assessment (SOFA) score for prediction of mortality in operated patients with sepsis due to intra-abdominal infection.
Methods
Eighty-eight septic patients operated on from January 2004 to June 2008 were evaluated retrospectively. The SOFA scores were measured four times in each patient: initial score, post-op (post-operation) score, POD1 (first post-operative day) score, and POD2 (second post-operative day) score. The maximum score and mean score were obtained from these measurements. These scores were compared between groups of patients classified by mortality. D scores (D0, D1, D2) reflecting the differences between subsequent scores were compared between the surviving group and deceased group according to re-operation.
Figures and Tables
Fig. 1
The relationship between delta sequential organ failure assessment (SOFA) score and mortality according to re-operation. In patients not undergoing re-operation (A), the sequential changes of delta SOFA scores between live and dead differed significantly (P=0.021). The former had a gradual reducing trend, while the latter had an abrupt increasing trend. In patients undergoing re-operation (B), however, both those sequential changes did not differ and had downward directions together.
Fig. 2
The interaction between the sequential changes of each delta sequential organ failure assessment (SOFA) scores and survival on condition of adjustment by re-operation. Live had a gradual reducing trend of delta SOFA scores while dead had an increasing trend (P=0.035).
Table 1
The sequential organ failure assessment (SOFA) score*
*values are with respiratory support; †to convert bilirubin from mg/dl to µmol/L, multiply by 17.1; ‡adrenergic agents administered for at least 1 hour (dose given are in µg/kg per minute); §to convert creatnine from mg/dl to µmol/L, multiply by 88.4; ∥MAP = mean arterial pressure; ¶Dop = dopamine; **Dob = dobutamine; ††Epi = epinephrine; ‡‡Norepi = norepinephrine; §§GCS = Glasgow Coma Score.
Table 3
The relationship between mortality and each SOFA score transformed by cut-off value using by Receiver Operating Characteristic (ROC) curve analysis
Table 4
The relationship between D score and mortality according to re-operation
The values are mean±standard deviation. *D0 = postop score-initial score; †D1 = POD1 score-initial score; ‡D2 = POD2 score-initial score; §Analyzed by repeated measured ANOVA and the others student's t-test; ∥On condition that it was adjusted by re-operation, difference between sum of each D scores and survival was marginally significant (P=0.070), and also interaction between the sequential changes of each D scores and survival was significant (P=0.035).
References
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