Does the SOFA Score Have the Ability to Predict Length of Stay and Mortality as well as Other Scorings?

Authors

  • Artrien Adhiputri Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta https://orcid.org/0000-0001-7345-8942
  • Brigitta Devi Anindita Hapsari Dr. Moewardi Regional General Hospital - Universitas Sebelas Maret Hospital, Sukoharjo https://orcid.org/0009-0004-6318-0341
  • Reviono Reviono Dr. Moewardi Regional General Hospital - Universitas Sebelas Maret Hospital, Sukoharjo
  • Aditya Alfarizi Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta
  • Raninditya Damayanti Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta

DOI:

https://doi.org/10.36497/jri.v45i1.637

Keywords:

APACHE II, mortality, pneumonia, SOFA, SAPS II

Abstract

Background: In the intensive care unit (ICU), critically sick pneumonia has a high mortality rate, so forecasting the prognosis is crucial for making decisions. Early detection of clinical deterioration and the implementation of early intervention and care can be achieved through the use of scoring systems. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is a better system in predicting mortality in critically ill patients. However, in this study, we aim to observed  the use of the Sequential Organ Failure Assessment (SOFA) score as a predictor of mortality and length of stay (LOS).

Methods: From April to August 2023, we treated 125 critically sick pneumonia patients in the ICU as part of a prospective observational research. An integrated ICU mortality calculator was used to assess the performance of the APACHE II, Simplified Acute Physiology Score II (SAPS II), and SOFA scores. Descriptive statistics will be used for data analysis, and the Fisher exact test and Chi-square test will be used for testing. logistic regression and linear regression methods are used in multivariate analysis. If the p-value is less than 0.05, it will be statistically significant.

Results: APACHE II, SAPS II, and SOFA scores were significant in predicting the outcome of critically ill pneumonia patients (cut-off of ≥14.5, ≥34.5, and ≥3.5, respectively). The Spearman rank correlation for LOS shows that APACHE II, SOFA, and SAPS II scores have a very weak relationship with the p-values are 0.121, 0.766, and 0.436, respectively.

Conclusion: The SOFA score is a good mortality predictor in critically ill pneumonia patients yet is simpler and easier to use in all settings in the hospital.

Downloads

Download data is not yet available.

References

1. Reviono. Pendahuluan. In: Harsini, editor. Pneumonia: adakah tempat untuk pemberian antiinflamasi. 1st ed. Surakarta: UNS Press; 2017. p. 1–8.

2. Assefa M. Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns. Pneumonia. 2022;14(1):4.

3. Talwar D, Sharma RK. Epidemiology and risk factors of pneumonia. In: Jindal SK, Chetam-bath R, editors. World Clinics Pulmonary & crit-ical care medicine: Pneumonia. 1st ed. New Delhi, London, Panama: Jaypee Brothers Medi-cal Publishers P Ltd; 2019.

4. Rider AC, Frazee BW. Community-Acquired Pneumonia. Emerg Med Clin North Am. 2018;36(4):665–83.

5. Cillóniz C, Cardozo C, García-Vidal C. Epide-miology, pathophysiology, and microbiology of community-acquired pneumonia. Ann Res Hosp. 2018;2:1.

6. Ungureanu V. Bacterial sepsis. Infectio.ro. 2017;3(51).

7. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):E1063–143.

8. Willis BH, Coomar D, Baragilly M. Clinical scores in primary care. Br J Gen Pract. 2020;70(695):279.

9. Chen J, Liu B, Du H, Lin H, Chen C, Rao S, et al. Performance of CURB-65, PSI, and APACHE-II for predicting COVID-19 pneumonia severity and mortality. Eur J Inflamm. 2021;19:1–12.

10. Mohan A, Shrestha P, Guleria R, Pandey R, Wig N. Development of a mortality prediction formu-la due to sepsis/severe sepsis in a medical in-tensive care unit. Lung India. 2015;32(4):313–9.

11. Jentzer JC, Bennett C, Wiley BM, Murphree DH, Keegan MT, Gajic O, et al. Predictive value of the Sequential Organ Failure Assessment score for mortality in a contemporary cardiac in-tensive care unit population. J Am Heart Assoc. 2018;7(6):e008169.

12. Thakur R, Naga Rohith V, Arora JK. Mean SOFA score in comparison with APACHE II score in predicting mortality in surgical patients with sepsis. Cureus. 2023;15(3):e36653.

13. Maryani N, Wisudarti CFR. The comparison score of SPEEDS, MEDS, SOFA, APACHE II, and SAPS II as predictor of sepsis mortality: A systematic review. Asian Journal of Social and Humanities. 2023;2(1):193–203.

14. Furqan A, Naseer M, Tabassum R. Comparison of sensitivity, specificity and accuracy of APACHE II, SAPS II and SOFA scoring systems as predictors. Pakistan Journal of Medical and Health Sciences. 2021;15(12):3364–6.

15. Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American Thoracic Society. Clinical Infectious Diseases. 2016;63(5):e61–111.

16. Raschke RA, Agarwal S, Rangan P, Heise CW, Curry SC. Discriminant accuracy of the SOFA score for determining the probable mortality of patients with COVID-19 pneumonia requiring mechanical ventilation. JAMA - Journal of the American Medical Association. 2021;325(14):1469–70.

17. Nikzad Jamnani A, Gholipour Baradari A, Kar-gar-soleimanabad S, Javaheri S. Predictive per-formance of SOFA (Sequential Organ Failure Assessment) and qSOFA (quick Sequential Or-gan Failure Assessment) for in-hospital mortali-ty in ICU patients with COVID-19 of referral center in the north of Iran a retrospective study. Annals of Medicine & Surgery. 2023;85(11):5414–9.

18. ClinCalc. Combination ICU mortality malculator (APACHE II, SAPS II, SOFA) [Internet]. 2018 [cited 2023 Aug 31]. Available from: https://clincalc.com/IcuMortality/

19. Regunath H, Oba Y. Community-acquired pneumonia. Treasure Island (FL): StatPearls Publishing; 2024.

20. Cillóniz C, Torres A, Niederman MS. Manage-ment of pneumonia in critically ill patients. BMJ. 2021;375:e065871.

21. Viasus D, Cillóniz C, Cardozo CG, Puerta P, Garavito A, Torres A, et al. Early, short and long-term mortality in community-acquired pneumonia. Ann Res Hosp. 2018;2:5.

22. Huang D, He D, Gong L, Wang W, Yang L, Zhang Z, et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia and type 2 diabetes mellitus. Crit Care. 2021;25(1):419.

23. Zhou XY, Ben SQ, Chen HL, Ni SS. A compari-son of APACHE II and CPIS scores for the pre-diction of 30-day mortality in patients with venti-lator-associated pneumonia. International Jour-nal of Infectious Diseases. 2015;30:144–7.

24. Allyn J, Ferdynus C, Bohrer M, Dalban C, Val-ance D, Allou N. Simplified acute physiology score II as predictor of mortality in intensive care units: A decision curve analysis. PLoS One. 2016;11(10):e0164828.

25. Liu C, Suo S, Luo L, Chen X, Ling C, Cao S. SOFA Score in relation to sepsis: Clinical impli-cations in diagnosis, treatment, and prognostic assessment. Comput Math Methods Med. 2022;2022:7870434.

26. Iskandar A, Siska F. Analisis hubungan sequen-tial organ failure assessment (SOFA) score dengan mortalitas pasien sepsis. Jurnal Kesehatan Andalas. 2020;9(2):168–73.

27. Sihotang FMS, Lesmana H. Analisis skor APACHE II dan APACHE IV dalam memprediksi lama rawat pada pasien kritis. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing). 2023;9(2):270–7.

28. Tian Y, Yao Y, Zhou J, Diao X, Chen H, Cai K, et al. Dynamic APACHE II score to predict the outcome of intensive care unit patients. Front Med (Lausanne). 2022;8:744907.

29. Czajka S, Ziębińska K, Marczenko K, Posmyk B, Szczepańska AJ, Krzych ŁJ. Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: A cohort study. BMC Anesthesiol. 2020;20(1):296.

30. Hosseini M, Ramazani J. Evaluation of acute physiology and chronic health evaluation II and sequential organ failure assessment scoring systems for prognostication of outcomes among Intensive Care Unit’s patients. Saudi J Anaesth. 2016;10(2):168–73.

Downloads

Published

2025-01-31

Issue

Vol. 45 No. 1 (2025)

Section

Original Article

License

Copyright (c) 2025 Artrien Adhiputri, Brigitta Devi Anindita Hapsari, Reviono Reviono, Aditya Alfarizi, Raninditya Damayanti

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

  1. The authors own the copyright of published articles. Nevertheless, Jurnal Respirologi Indonesia has the first-to-publish license for the publication material.
  2. Jurnal Respirologi Indonesia has the right to archive, change the format and republish published articles by presenting the authors’ names.
  3. Articles are published electronically for open access and online for educational, research, and archiving purposes. Jurnal Respirologi Indonesia is not responsible for any copyright issues that might emerge from using any article except for the previous three purposes.

Similar Articles

1-10 of 83

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)

1 2 > >>