Impact of Admission SOFA Score and 48-Hour Delta SOFA on Clinical Outcomes of Critically Ill Patients

Author(s): Cristiana SQ Vasconcelos, Manuel D de La Cruz, Gabriel HLB Nascimento, José RA Azevedo

Background

Assessment of SOFA score, determined upon ICU admission, can identify patients at risk of unfavorable outcomes and trigger assessment and application of interventions, of which effectiveness can be evaluated by determining the SOFA score trend after 48 hours. Herein, we evaluated the impact of an admission SOFA score ≥ 2 and the 48-hour delta SOFA on critically ill patient outcomes.

Methods

This retrospective, observational cohort study included 1101 patients admitted to three ICUs of a tertiary hospital from January 01 to December 31, 2020. SOFA scores- determined upon ICU admission and 48 hours thereafter -denoted three patient groups: those with admission SOFA scores below 2 (n = 348), those with admission SOFA scores ≥ 2 whose 48-hour delta SOFA reflected improvement (SOFA after 48 hours < admission SOFA) (n = 415), and those with admission SOFA scores ≥ 2 that had increased or remained unchanged after 48 hours (SOFA after 48 hours ≥ admission SOFA) (n = 338).

Results

Group 1 patients were significantly younger and less severely ill and both ICU (3.4%) and hospital (8.6%) mortality were significantly lower than those of Group 2 and 3 patients. Among these, patients in Group 3 were older and had significantly higher mortality, both in the ICU (27.3% versus 10.1%, p < 0.001) and hospital (53.8% versus 14.9%, p < 0.001), compared to Group 2 patients.

Conclusion

We demonstrated that the admission SOFA score and 48-hour delta SOFA are predictors of prognosis in a nonselective cohort of critically ill patients.