The Ability of SOFA Score to Predict Mortality Rate and ICU Length of Stay for Trauma Patients

Abstract

Background:

The sequential organ failure assessment (SOFA) is one of the most valid outcome prediction systems for patients with sepsis. Numerous methods have been used to predict outcome in trauma patients.

Objectives:

This study examined the validity of the SOFA scoring system for predicting outcome in multiple trauma patients admitted to the intensive care unit (ICU) of Bahonar Hospital, Kerman, Iran.

Methods:

This was a prospective cohort study conducted from September 2017 to September 2018 on trauma patients admitted to the ICU at Bahonar Hospital, Kerman, Iran. After data collection, the discriminatory ability of SOFA (to discriminate between survivors and non-survivors) and its calibration ability (to make predicted probabilities in agreement with the actual outcomes) were calculated. P < 0.05 was regarded as the significance level.

Results:

In this study, 454 patients aged 18 - 91 years were evaluated. Their mean age was 51.96 ± 18.15 years. Two hundred and eighty (61.7%) of the patients were male and one hundred and seventy-four (38.3%) were female. The mortality rate in the study was 27.3% (n = 123), and the discriminatory power of SOFA was poor (AUC = 0.648). Based on the Youden Index (sensitivity and specificity), an optimal cut-off point of 5.5 (sensitivity 58.4% and specificity 69%) was calculated for SOFA. The ROC area under the curve was 0.648 ± 0.036 (P = 0.001).

Conclusions:

In this study, the discriminatory and calibration power of SOFA were poor and acceptable, respectively. SOFA was accurate in predicting the probability of death among the trauma patients in the ICU.