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Mean SOFA Score in Comparison With APACHE II Score in Predicting Mortality in Surgical Patients With Sepsis

Background: Sepsis is a medical and surgical emergency that describes the body’s systemic immunological response to an infectious process that can lead to end-stage organ dysfunction and death. Various clinical and biochemical parameters serve as indicators of organ dysfunction in patients with seps...

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Detalles Bibliográficos
Autores principales: Thakur, Radhika, Naga Rohith, Vakulabharanam, Arora, Jainendra K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128886/
https://www.ncbi.nlm.nih.gov/pubmed/37113362
http://dx.doi.org/10.7759/cureus.36653
Descripción
Sumario:Background: Sepsis is a medical and surgical emergency that describes the body’s systemic immunological response to an infectious process that can lead to end-stage organ dysfunction and death. Various clinical and biochemical parameters serve as indicators of organ dysfunction in patients with sepsis. Most familiar among them are the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Mortality Prediction Score (MPM), and Simplified Acute Physiology Score (SAPS). Methodology: A comparative study of APACHE II and SOFA scores was done at the time of admission in a total of 72 patients with sepsis and compared with the mean SOFA score. In our study, the SOFA score was measured serially and the mean SOFA score was calculated. All patients were selected according to the definition of sepsis (Sepsis-3). The ROC curve, the sensitivity, and the specificity were calculated to analyze the diagnostic value of SOFA, APACHE II, and the mean SOFA score. For all statistical tests, a “p-value” less than 0.05 was taken to indicate a significant difference. Results: Our study showed that the mean SOFA score had a sensitivity of 93.65 and a specificity of 100, and on comparing the AUC of mean SOFA with APACHE II (Day 1) and SOFA (Day 1) - we got the P-value 0.0066 and 0.0008, which shows a statistically significant difference. So, we can say that the mean SOFA score is better than D(1 )(day 1 of admission) APACHE II & SOFA scores in predicting mortality in surgical patients with sepsis. Conclusions: APACHE II and SOFA scores are equally effective in assessing mortality in surgical patients with sepsis at the time of admission. However, if we take serial measurements of SOFA scores and calculate the mean SOFA score it becomes a very useful tool for predicting mortality.