The purpose of this study was to determine the relative contribution of each individual SOFA organ sub-score for prediction of mortality in CICU patients without any missing SOFA sub-score data, in order to facilitate potential future modification of the SOFA score to better fit the CICU population.
The absence of available data for calculating ICU severity of illness scoring models influences model performance by underestimating illness severity and mortality risk, raising questions about the accuracy of the SOFA score in patients with missing data. However, data to calculate the respiratory and liver SOFA sub-scores were available in fewer than one-third of patients as is customary in such models, missing data were imputed as normal. The cardiovascular and renal SOFA organ sub-scores had the highest discrimination for short-term mortality in our prior study. We previously reported very good discrimination for hospital mortality using the SOFA score on the first CICU day in our CICU population, although calibration was suboptimal. The SOFA score contains fewer variables and is simpler to calculate compared to other ICU risk prediction models, yet it can accurately predict short-term mortality in CICU populations. The Sequential Organ Failure Assessment (SOFA) score is an illness severity score developed in patients with sepsis, including a 4-point assessment of dysfunction in each of 6 organ systems (central nervous system, cardiovascular, respiratory, renal, liver and coagulation). The use of disease-specific risk prediction scores in the CICU is limited by the presence of undifferentiated clinical syndromes in patients with multiple acute and chronic cardiovascular disease processes, making general ICU severity of illness scoring models potentially advantageous. Risk stratification models allow prediction of adverse outcomes in this increasingly complex CICU patient population in order to facilitate care planning and therapeutic intervention. The CICU population has evolved to include patients with acute and chronic multi-organ dysfunction and superimposed cardiac pathology, similar to other intensive care unit (ICU) populations. reported their classification of patients with acute myocardial infarction. Risk prediction scores have guided care in the cardiac intensive care unit (CICU) since Killip, et al.
Oxford Acute Severity of Illness Score OR, This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: The author(s) received no specific funding for this work.Ĭompeting interests: The authors have declared that no competing interests exist.Īcute Physiology and Chronic Health Evaluation AUROC,Īrea under the receiver-operator characteristic curve BMI, Received: JanuAccepted: ApPublished: May 20, 2019Ĭopyright: © 2019 Jentzer et al. PLoS ONE 14(5):Įditor: Robert Ehrman, Wayne State University, UNITED STATES Citation: Jentzer JC, Bennett C, Wiley BM, Murphree DH, Keegan MT, Barsness GW (2019) Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit.