Serial evaluation of SOFA score in a Brazilian teaching hospital

Objectives: To evaluate the application of the Sequential Organ Failure Assessment (SOFA) in describing the severity of organ dysfunctions and the associated mortality rates in critically ill patients at a teaching hospital. Research methodology: Prospective longitudinal study performed in 1164 adult, critically ill patients who were admitted consecutively into intensive care units between January 2004 and December 2005. We analysed static evaluation of SOFA and dynamic changes in the SOFA scores. The discriminative power of SOFA was evaluated using ROC curves. Results: There was an increase in the mortality rate when the SOFA scores increased (chi(2)(trend)= 272.08, p < 0.001, increase rate = 0.13). The SOFA score on the third day in the ICU had the highest area under the curve for hospital mortality (AUC: 0.817 +/- 0.0133, CI 95%: 0.792-0.840). We analysed SOFA score changes with time and observed that patients with low scores (0-5) upon admission and who increased to the medium or high SOFA groups had a significantly higher mortality rate (51.7 and 100%, respectively, p < 0.001). Conclusions: Applying SOFA to critically ill patients effectively described the severity of organ dysfunctions, and higher SOFA scores had a positive association with mortality. (C) 2009 Elsevier Ltd. All rights reserved.