Methods

We conducted a prospective observational review of 100 consecutive patients admitted to our ICU. We collected data relating to daily maximum organ dysfunction scores. Outcome was defined in terms of length of ICU stay and ICU mortality.

Results

We included 100 patients (62 males), mean age 60.9 years. Of these admissions, 45 were elective surgical, 22 emergency surgical, 33 medical. The median Sequential Organ Failure Assessment (SOFA) score on admission was 4.50 (IQR 4). The median maximum SOFA score was 5.00 (IQR 5). The median length of ICU stay was 3.0 days (IQR 3). The overall ICU mortality rate was 14.0%. For patients with a maximum SOFA score ≤8, mortality was 5.1% – vs 45.5% for those whose maximum SOFA score was >8 (P < 0.001). Sixty-four per cent of patients scored their maximum SOFA score on admission. In patients whose SOFA score increased after admission, the mortality was 24.3%. Logistic regression analysis showed the maximum SOFA score bore a stronger correlation with mortality than admission SOFA score. See Figure 1.

Figure 1
figure 1

Median length of ICU stay in patients with an admission SOFA score >8 vs those whose admission SOFA score was ≤8 (P = 0.001).

Conclusion

Maximum and admission SOFA scores are of prognostic value in the intensive care setting; allowing patients with increased risk of mortality and prolonged stay to be identified.