DOI: http://dx.doi.org/10.18203/2349-2902.isj20210385

Sepsis induced sequential organ failure assessment score as a prognostic marker in surgical sepsis: a study of 30 cases in 02 years

Tushar Nagyan, Mriganko S. Ray, Priyanshu M. Varshney, Sarvpreet S. Malhi, Naresh A. Modi, Digpal H. Thakore, Sandhya Gupta

Abstract


Background: For the last few decades critical care medicine has been reinventing and fine-tuning organ dysfunction grading to establish a survival scoring system to accurately predict survivality and organ salvageability of critically ill patient in intensive care unit (ICU). The sequential organ failure assessment (SOFA) score assesses the performance of several organ systems in the body and assigns a score, where higher the SOFA score, higher the likelihood of mortality and morbidity. Early prediction of outcome in surgical sepsis is very likely to aid suitable modification of management strategies 13. This may improve prognosis in such patients and prevent mortality to some extent.  

Methods: Observational and prospective study of 30 cases, aged>18 years & patients admitted to post-operative ward and surgical intensive care unit (SICU) with suspected surgical infection, and with two or more criteria of SIRS.

Results: In this study out of total 30 patients 63.3% patients survived and 36.6% succumbed to their illness. Our study depicted significant increase in mortality rate when the SOFA score was above 12. Ventilated patient showed a higher mortality rate. Delta, mean, total SOFA Score were statistically significant in our study.

Conclusions: SOFA score is useful in predicting mortality and morbidity in critically ill patients, because has a strong correlation between a rise in the score and mortality in all stages of admission. In our study, out of 09 patients whose T0 SOFA score was very high (above 12) out of which 03 patients only survived.


Keywords


Sepsis, SOFA score, Surgical intensive care unit, Postoperative, SIRS

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References


Vincent JL, Moreno R, Takala J. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intens Care Med. 1996;22:707-10.

Ho KM, Lee KY, Williams T. Comparison of Acute Physiology and Chronic Health Evaluation (APACHE) II score with organ failure scores to predict hospital mortality. Anaesthes. 2007;62(5):466–73.

Gosling P, Czyz J, Nightingale P. Microalbuminuria in the intensive care unit:Clinical correlates and association with outcomes in 431 patients. Crit Care Med. 2006;34(8):2158–66.

Bota DP, Melot C, Ferreira FL, Ba VN, Vincent JL. The multiple organ dysfunction score (MODS) versus the sequential organ failure assessment (SOFA) score in outcome prediction. Intens Care Medic. 2002;28(11):1619-24.

Pettila V, Pettila M, Sarna S. Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Crit Care Med. 2002;30(8):1705–11.

Junger A, Engel J, Benson M. Discriminative power on mortality of a modified Sequential Organ Failure Assessment score for complete automatic computation in an operative intensive care unit. Crit Care Med. 2002;30(2):338–42.

Zygun DA, Laupland KB, Fick GH, Sandham JD, Doig C. Limited ability of SOFA and MOD scores to discriminate outcome: a prospective evaluation in 1,436 patients. Can J Anaesth. 2005;52(3):302–8.

Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, et al. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis related Problems of the ESICM. Intens Care Med. 1999;25(7):686–96.

Rivera-Fernandez R, Nap R, Vazquez-Mata G, Mirinda DR. Analysis of physiologic alterations in intensive care unit patients and their relationship with mortality. J Crit Care. 2007;22(2):120–8.

Jacobs S, Zuleika M, Mphansa T. The Multiple Organ Dysfunction Score as a descriptor of patient outcome in septic shock compared with two other scoring systems. Crit Care Med. 1999;27(4):741–4.

Esper AM, Martin GS. Extending international sepsis epidemiology: the impact of organ dysfunction. Critic Care. 2009;13:120.

Jones AE, Trzeciak S, Kline JA. The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med. 2009;37(5):1807-8.

Anami EHT, Grion CMC, Cardoso LTQ, Kauss IAM, THomazini MC, Zampa HB et al. Serial evaluation of SOFA score in a Brazilian teaching hospital. Intensive Crit Care Nurs. 2010;26:75-82.