• Journal of critical care · Jun 2020

    Multicenter Study Observational Study

    A new simplified and accurate sa-SOFA score.

    • Charles-Hervé Vacheron, Arnaud Friggeri, Jean Iwaz, Bernard Allaouchiche, Julien Bohe, Guillaume Monneret, Fabienne Venet, Martin Cour, Laurent Argaud, Frédéric Aubrun, Thomas Rimmele, Alexandre Pachot, Vincent Piriou, Alain Lepape, and Delphine Maucort-Boulch.
    • Département d'Anesthésie-Réanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, France; Université Claude Bernard - Lyon 1, Villeurbanne, France; Laboratoire de Biométrie et de Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France. Electronic address: charles-herve.vacheron@chu-lyon.fr.
    • J Crit Care. 2020 Jun 1; 57: 240-245.

    PurposeSeveral remarks have been raised regarding the variables and cut-points used in the Sequential Organ Failure Assessment (SOFA) score. This study revisited the SOFA score and created a new simplified and accurate sa-SOFA score.MethodsThe study grouped four prospective cohorts (2005-2016) of patients with Systemic Inflammatory Response Syndrome. It collected 28-day mortality, sociodemographic characteristics, and the SOFA score with all variable values at Day 1. A logistic regression analysis was used to select the most relevant variables and a minimum p value approach with a 10-fold cross-validation were used to find the optimal partition of selected variables. The minimum number of cut-points (2, 3, or 4) was also tested by comparing the distributions of areas under receiver operating characteristic (AUROC) curves.ResultsAmong the 1436 participants, 416 died within 28 days (28.9%). The sa-SOFA kept one variable per dimension and two cut-points per variable. The AUROC curves that investigated the abilities of the sa-SOFA and SOFA scores to predict 28-day mortality were 0.739 [0.712-0.768] and 0.687 [0.656-0.717], respectively (p-value of DeLong test <0.001).ConclusionKeeping the conventional SOFA dimension variables, the new sa-SOFA proved to be simpler and more accurate in predicting 28-day mortality.Copyright © 2019 Elsevier Inc. All rights reserved.

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