The following is a summary of “Validity of the total SOFA score in patients ≥ 80 years old acutely admitted to intensive care units: a post-hoc analysis of the VIP2 prospective, international cohort study,” published in the October 2023 issue of Critical Care by Polok et al.
The performance of the Sequential Organ Failure Assessment (SOFA) score in older critically ill adults needs to be better understood. Researchers started a retrospective study to assess the prognostic value of the SOFA score, a six-organ system physiological assessment tool.
They analyzed data between 2018 and 2019 in 22 countries involving consecutive patients aged ≥80 years admitted to intensive care units (ICUs). Logistic regression assessed the link between organ dysfunction severity and mortality in ICU patients tracked for 30 days.
The results showed 3,882 patients; the median SOFA score was 6 (IQR: 4–9). ICU mortality stood at 26.1% (95% CI 24.7–27.5%); on day 30, it was 38.7% (95% CI 37.1–40.2%). Organ failure, defined as a SOFA score ≥ 3, was associated with varying adjusted odds ratios (aORs) for ICU mortality based on the affected organ system: respiratory, aOR 1.53 (95% CI 1.29–1.81); cardiovascular, aOR 1.69 (95% CI 1.43–2.01); hepatic, aOR 1.74 (95% CI 0.97–3.15); renal, aOR 1.87 (95% CI 1.48–2.35); central nervous system, aOR 2.79 (95% CI 2.34–3.33); coagulation, aOR 2.72 (95% CI 1.66–4.48). Modeling varying levels of organ dysfunction resulted in aORs of 0.57 (95% CI 0.33–1.00) when patients scored 2 points in the cardiovascular system and 1.01 (0.79–1.30) when the cardiovascular SOFA score was 3.
They concluded that the SOFA score’s prognostic value varies by component, and the cardiovascular feature requires revision.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01191-0