Diagnostic Efficacy of SOFA Score in Predicting Outcome and Mortality: An ICU Experience from Pakistan

Abstract

Objective: To determine the cut-off value of Sequential Organ Failure Assessment score at the time of admission in Intensive Care Unit to predict mortality and outcome in critically ill patients.

Materials and Methods: This cross-sectional, descriptive study was undertaken at Intensive Care Unit of Rawalpindi Teaching Hospital, Rawalpindi, Pakistan between April and August 2023. SOFA score of all critically ill patients at the time of admission in ICU and their outcome (expired or discharged) was recorded. Receiver Operator Characteristics Curve (ROC) was drawn for SOFA score and mortality. Cut off value for SOFA score was calculated. Outcome of patients above and below the cut off value for SOFA score was studied using Chi-square test.

Results: A total of 100 patients (54% females and 46% males) were included in the study with mean patient age of 68.93±11.09 years. Out of 100  patients,  48 (48%)  improved  and  52  (52%)  expired. The Mean  initial  SOFA  score  was  5.44±3.99 in patients who improved and 9.91±4.20 in patients who expired.  Coordinates  of  the  ROC curve  showed  that  SOFA score  cut  off  value  7.5  had  best  corresponding  sensitivity  (0.777)  and  specificity  (0.740). The patients were categorized to Group  I  (SOFA  score ≤7),  and  Group  II (SOFA  score ≥8). 34.04% of the Group I and 75.47% of the Group II patients expired (p-value 0.0000001)

Conclusions: Mortality was higher in  patients who had higher SOFA score at the time of admission in Intensive Care Unit. At admission SOFA scores (≤7 and >8) are best predictor of outcome in critically ill patients.