The Impact of Sequential Organ Failure Assessment (SOFA) Score on Mortality in Geriatric Patients With Sepsis and Septic Shock in the ICU

Objective One of the most common causes of mortality and morbidity in elderly patients is sepsis. Malnutrition is widespread in elderly patients, affecting mortality and morbidity. The present study aimed to evaluate the clinical features of patients hospitalized in the tertiary intensive care unit with the diagnosis of sepsis, as well as the effects of the Sequential Organ Failure Assessment (SOFA) score, prealbumin, albumin, and other laboratory parameters on hospital mortality. Methods The patients were divided into two groups according to their survival. The demographic and clinical characteristics of the two groups were compared. Independent risk factors affecting mortality were determined by logistic regression. Results A total of 653 patients admitted to the medical ICU were evaluated out of which 254 geriatric patients with sepsis and septic shock were included. There was in-hospital mortality in 122 (48%) patients. There was no difference in age in both groups (76 (71-84) vs. 76 (70-84), p=0.896). BUN (p=0.013), LDH (p=0.014), LDH/albumin (p<0.001), BUN/albumin (p<0.001), lactate/albumin (p= 0.007), and CRP/albumin (p=0.001) was higher in deceased patients compared to surviving patients. Prealbumin and albumin were lower in non-survivors (p=0.001). When the factors affecting mortality were examined by multivariate analysis, it was determined that none of the laboratory parameters alone predicted mortality. SOFA score was the only independent risk factor indicating mortality in the geriatric patient population with sepsis (OR=1.886 (1.410-2.510), p<0.001). Conclusion In conclusion, we demonstrated that high age and parameters of nutrition indicators did not affect mortality in geriatric patients hospitalized in the intensive care unit due to sepsis. In our study, the SOFA score was an independent risk factor affecting mortality in geriatric patients with sepsis, as in all sepsis cases.