• Makoto Arakawa, Jerrold H Levy, Kenji Fujimori, Kenta Kondo, and Toshiaki Iba.
• Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: arakawa@nihon-pharm.co.jp.
• J Crit Care. 2021 Aug 1; 64: 108-113.

PurposeThe change in the sequential organ failure assessment (SOFA) score from the entry day, a delta-SOFA (SOFAΔ), has been proposed as a better indicator for predicting mortality, and potentially as an endpoint in clinical trials. However, there are some concerns that the value of the absolute SOFA score has not been considered. The purpose of the study is to examine whether the addition of an absolute SOFA score can increase the predictive performance of SOFAΔ.Materials And MethodsData obtained from 297 patients with sepsis-associated disseminated intravascular coagulopathy (DIC) in multiinstitutional post-marketing surveys were analyzed retrospectively. The SOFAComb (SOFAΔ score + absolute SOFA score) and SOFAΔ were calculated, and the performance of each indicator was analyzed in terms of predictive ability for 28-day mortality.ResultsThe area under the receiver operating curve (AUC) for the mortality of SOFAComb on day 2, 4, 7 were significantly greater compared to those of SOFAΔ (P <0.001, =0.002, <0.001, respectively). In addition, the accuracy [(True positive + True negative) / total number at the best cutoff points] of SOFAComb was better than that of SOFAΔ.ConclusionsSOFAComb is simple to calculate and provides better predictive performance compared to SOFAΔ for predicting mortality.Copyright © 2021 Elsevier Inc. All rights reserved.

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