Critical Care

, 17:P50 | Cite as

Organ dysfunction and mortality in septic patients admitted to an ICU

  • Thais Almeida Rodrigues
  • Louise Cristhine de Carvalho Santos
  • Jaqueline Lima de Souza
  • Fernanda Vilas Bôas Araújo
  • Thiago Alves Silva
  • Pedro Henrique Gomes Rocha
  • Lucila de Jesus Almeida
  • Jacqueline Rodrigues de Carvalho
  • Mariana Pinheiro Barbosa de Araújo
  • Lucas Garcia de Souza Godoy
  • Kátia Crys Moura Ogliari
  • Pedro Nery Ferreira Júnior
  • Adriell Ramalho Santana
  • Fábio Ferreira Amorim
  • Clayton Barbieri de Carvalho
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Keywords

Nervous System Receiver Operating Characteristic Cardiovascular System Emergency Medicine Renal Impairment 

Background

Sequential Organ Failure Assessment (SOFA) is a largely used score in the evaluation of organ dysfunction/failure in septic patients [1]. Repeated scoring can also assess patient condition and disease development [2]. The present study aims to describe the association between SOFA score and the organ dysfunction components of this score with mortality in septic patients admitted to an ICU.

Materials and methods

Prospective study conducted on patients admitted to the ICU of Hospital Regional de Samambaia, Brasília, DF, Brazil, during 7 months. The SOFA was evaluated at the time of admission to the ICU. Patients were divided into two groups: survivors group (SG) and nonsurvivors group (NSG). Accuracy of SOFA and the organ dysfunction components of SOFA score to predict ICU mortality were measured with the area under the receiver operating characteristic (ROC) curve.

Results

One hundred and seven patients were enrolled. Mean age was 53 ± 20, APACHE II 14 ± 6, SAPS 3 52.9 ± 14.9 and SOFA 6.2 ± 3.3. ICU mortality was 34.6% (n = 37). The SOFA score was higher in nonsurvivors (7.4 ± 3.0 vs. 5.8 ± 3.4, P = 0.01), cardiovascular (2.0 ± 1.8 vs. 1.4 ± 1.6, P = 0.01) and kidney dysfunctions (0.7 ± 1.0 vs. 0.4 ± 0.9, P = 0.04) being higher in this group. There were no differences between the groups regarding coagulation (0.4 ± 0.8 vs. 0.4 ± 0.8, P = 0.59), liver (0.0 ± 0.3 vs. 0.0 ± 0.7, P = 0.65), respiratory (2.0 ± 1.2 vs. 1.6 ± 1.4, P = 0.87), and neurologic (2.2 ± 1.7 vs. 1.7 ± 1.6, P = 0.96) organ dysfunctions. The area under the ROC curve (Figure 1) for SOFA was 0.650 (95% CI 0.541 to 0.759). The components of the cardiovascular system, renal system, coagulation, liver, respiratory, and nervous systems had areas under the ROC curve of 0.612 (95% CI 0.501 to 0.732), 0.565 (95% CI 0.478 to 0.712), 0.484 (95% CI 0.369 to 0.600), 0.457 (95% CI 0.344 to 0.571), 0.580 (95% CI 0.469 to 0.691), and 0.582 (95% CI 0.465 to 0.699), respectively.
Figure 1

ROC curve for SOFA.

Conclusions

The SOFA score was moderately associated with ICU mortality. The scores for cardiovascular and renal impairment were individually associated with mortality.

References

  1. 1.
    Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S: Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on 'sepsis-related problems' of the European Society of Intensive Care Medicine. Crit Care Med. 1998, 26: 1793-1800. 10.1097/00003246-199811000-00016.CrossRefPubMedGoogle Scholar
  2. 2.
    Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996, 22: 707-710. 10.1007/BF01709751.CrossRefPubMedGoogle Scholar

Copyright information

© Rodrigues et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • Thais Almeida Rodrigues
    • 1
  • Louise Cristhine de Carvalho Santos
    • 1
  • Jaqueline Lima de Souza
    • 1
  • Fernanda Vilas Bôas Araújo
    • 1
  • Thiago Alves Silva
    • 1
  • Pedro Henrique Gomes Rocha
    • 1
  • Lucila de Jesus Almeida
    • 1
  • Jacqueline Rodrigues de Carvalho
    • 1
  • Mariana Pinheiro Barbosa de Araújo
    • 1
  • Lucas Garcia de Souza Godoy
    • 1
  • Kátia Crys Moura Ogliari
    • 1
  • Pedro Nery Ferreira Júnior
    • 1
  • Adriell Ramalho Santana
    • 2
  • Fábio Ferreira Amorim
    • 1
  • Clayton Barbieri de Carvalho
    • 3
  1. 1.Escola Superior de Ciências da SaúdeBrasíliaBrazil
  2. 2.Liga Acadêmica de Medicina Intensiva de BrasíliaBrazil
  3. 3.Hospital Regional de SamambaiaBrasíliaBrazil

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