Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
Copyright © 2022 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: all authors. Data curation: BK. Formal analysis: BK. Funding acquisition: BK. Methodology: all authors. Project administration: BK. Visualization: all authors. Writing–original draft: BK, VV. Writing–review & editing: all authors.
Values are presented as median (interquartile range), number (%), or mean±standard deviation.
APACHE: Acute Physiology and Chronic Health Evaluation; SAPS: Simplified Acute Physiology Score; SOFA: Sequential Organ Failure Assessment; mSOFA: modified SOFA; ICU: intensive care unit; LOS: length of stay.
Population |
All-cause in-hospital mortality |
All-cause ICU mortality |
All-cause 28-day mortality |
|||
---|---|---|---|---|---|---|
SOFA | mSOFA | SOFA | mSOFA | SOFA | mSOFA | |
All | 0.879 (0.862–0.896) | 0.891 (0.875–0.907)a | 0.871 (0.853–0.889) | 0.880 (0.863–0.898)c | 0.874 (0.856–0.892) | 0.887 (0.871–0.904)a |
Age ≤60 yr (n=695) | 0.895 (0.872–0.919) | 0.907 (0.885–0.930)b | 0.889 (0.865–0.913) | 0.899(0.877–0.922)c | 0.890 (0.865– 0.915) | 0.902 (0.878–0.925)b |
Age >60 yr (n=827) | 0.865 (0.840–0.889) | 0.877 (0.854–0.900)b | 0.855 (0.829–0.881) | 0.863 (0.837–0.889)d | 0.861 (0.836–0.885) | 0.875 (0.852–0.899)b |
Cirrhosis (n=83) | 0.905 (0.843–0.967) | 0.907 (0.845–0.969)d | 0.876 (0.792–0.959) | 0.879 (0.799–0.959)d | 0.879 (0.802–0.957) | 0.879 (0.801–0.958)d |
Total bilirubin ≥2 mg% (n=442) | 0.897 (0.868–0.926) | 0.892 (0.862–0.922)d | 0.857 (0.823–0.892) | 0.857 (0.822–0.892)d | 0.884 (0.852–0.915) | 0.883 (0.851–0.915)d |
Total bilirubin <2 mg% (n=1,080) | 0.880 (0.859–0.901) | 0.885 (0.864–0.905)b | 0.882 (0.861–0.904) | 0.885 (0.863–0.906)d | 0.879 (0.858–0.899) | 0.883 (0.863–0.904)b |
Community-acquired infection (n=1,036) | 0.871 (0.848–0.894) | 0.889 (0.867–0.910)a | 0.877 (0.854–0.900) | 0.891 (0.869–0.913)a | 0.869 (0.846–0.892) | 0.885 (0.863–0.906)a |
Nosocomial-acquired infection (n=486) | 0.877 (0.847–0.907) | 0.877 (0.847–0.907)d | 0.837 (0.803–0.872) | 0.837 (0.801–0.872)d | 0.861 (0.828–0.894) | 0.871 (0.839–0.902)d |
Septic shock (n=892) | 0.867 (0.843–0.890) | 0.880 (0.858–0.902)b | 0.825 (0.798–0.851) | 0.836 (0.809–0.862)c | 0.857 (0.833–0.882) | 0.871 (0.848–0.895)b |
Sepsis (n=630) | 0.843 (0.807–0.879) | 0.858 (0.824–0.892)b | 0.893 (0.860–0.926) | 0.902 (0.870–0.933)d | 0.842 (0.806–0.879) | 0.858 (0.823–0.893)b |
Lactate ≥2 mmol/L (n=972) | 0.875 (0.854–0.896) | 0.887 (0.866–0.907)b | 0.842 (0.818–0.867) | 0.852 (0.828–0.876)c | 0.866 (0.844–0.889) | 0.879 (0.857–0.900)b |
Lactate <2 mmol/L (n=550) | 0.847 (0.810–0.884) | 0.864 (0.829–0.899)b | 0.888 (0.852–0.923) | 0.899 (0.866–0.932)c | 0.847 (0.809–0.884) | 0.865 (0.829–0.901)a |
Variable | All patients (n=1,522) | Survivor (n=839) | Non-survivor (n=683) | P-value |
---|---|---|---|---|
Age (yr) | 63 (47–75) | 61 (45–74) | 64 (50–76) | 0.001 |
Male | 855 (56.2) | 459 (53.7) | 396 (46.3) | 0.200 |
Community-acquired infection | 1,036 (68.1) | 673 (80.2) | 363 (53.1) | <0.001 |
On mechanical ventilator | 1,359 (89.3) | 681 (81.2) | 678 (99.3) | <0.001 |
Vasopressor used | 1,263 (83.0) | 629 (74.9) | 634 (92.8) | <0.001 |
Site of infection | ||||
Respiratory | 780 (51.2) | 400 (47.7) | 380 (55.6) | 0.002 |
Gastrointestinal | 203 (13.3) | 122 (14.5) | 81(11.8) | 0.130 |
Primary bacteremia | 156 (10.2) | 64 (7.6) | 92 (13.5) | <0.001 |
APACHE II score | 22 (16–32) | 13 (17–21) | 32 (27–37) | <0.001 |
APACHE III score | 83 (59–122) | 61 (48–77) | 127 (106–144) | <0.001 |
SAPS II | 53 (39–72) | 41 (32–48) | 73 (63–85) | <0.001 |
SOFA score | 10 (6–13) | 7 (5–9) | 13 (10–15) | <0.001 |
mSOFA score | 9 (6–12) | 6 (4–9) | 12 (10–14) | <0.001 |
Each organ component of SOFA | ||||
Cardiovascular | 2.8±1.4 | 2.3±1.5 | 3.4±1.1 | <0.001 |
Pulmonary | 1.9±1.2 | 1.7±1.2 | 2.1±1.2 | <0.001 |
Neurological | 1.9±1.8 | 0.5±0.8 | 3.5±1.1 | <0.001 |
Renal | 1.3±1.3 | 1.2±1.3 | 1.4±1.3 | <0.001 |
Hematological | 0.9±1.2 | 0.7±1.1 | 1.2±1.3 | <0.001 |
Hepatological | 0.9±1.1 | 0.7±1.0 | 1.1±1.3 | <0.001 |
Serum lactate (mmol/L) | 2.8 (1.4–6.2) | 2 (1.1–3.9) | 4.2 (2.2–9.4) | <0.001 |
ICU LOS (day) | 4 (2–8) | 4 (2–7) | 4 (2–8) | 0.410 |
Hospital LOS (day) | 15 (7–31) | 18 (9–35) | 12 (4–26) | <0.001 |
All-cause in-hospital mortality | 683 (44.9) | - | - | - |
All-cause ICU mortality | 466 (30.6) | - | - | - |
All-cause 28-day mortality | 663 (43.6) | - | - | - |
Population | All-cause in-hospital mortality |
All-cause ICU mortality |
All-cause 28-day mortality |
|||
---|---|---|---|---|---|---|
SOFA | mSOFA | SOFA | mSOFA | SOFA | mSOFA | |
All | 0.879 (0.862–0.896) | 0.891 (0.875–0.907) |
0.871 (0.853–0.889) | 0.880 (0.863–0.898) |
0.874 (0.856–0.892) | 0.887 (0.871–0.904) |
Age ≤60 yr (n=695) | 0.895 (0.872–0.919) | 0.907 (0.885–0.930) |
0.889 (0.865–0.913) | 0.899(0.877–0.922) |
0.890 (0.865– 0.915) | 0.902 (0.878–0.925) |
Age >60 yr (n=827) | 0.865 (0.840–0.889) | 0.877 (0.854–0.900) |
0.855 (0.829–0.881) | 0.863 (0.837–0.889) |
0.861 (0.836–0.885) | 0.875 (0.852–0.899) |
Cirrhosis (n=83) | 0.905 (0.843–0.967) | 0.907 (0.845–0.969) |
0.876 (0.792–0.959) | 0.879 (0.799–0.959) |
0.879 (0.802–0.957) | 0.879 (0.801–0.958) |
Total bilirubin ≥2 mg% (n=442) | 0.897 (0.868–0.926) | 0.892 (0.862–0.922) |
0.857 (0.823–0.892) | 0.857 (0.822–0.892) |
0.884 (0.852–0.915) | 0.883 (0.851–0.915) |
Total bilirubin <2 mg% (n=1,080) | 0.880 (0.859–0.901) | 0.885 (0.864–0.905) |
0.882 (0.861–0.904) | 0.885 (0.863–0.906) |
0.879 (0.858–0.899) | 0.883 (0.863–0.904) |
Community-acquired infection (n=1,036) | 0.871 (0.848–0.894) | 0.889 (0.867–0.910) |
0.877 (0.854–0.900) | 0.891 (0.869–0.913) |
0.869 (0.846–0.892) | 0.885 (0.863–0.906) |
Nosocomial-acquired infection (n=486) | 0.877 (0.847–0.907) | 0.877 (0.847–0.907) |
0.837 (0.803–0.872) | 0.837 (0.801–0.872) |
0.861 (0.828–0.894) | 0.871 (0.839–0.902) |
Septic shock (n=892) | 0.867 (0.843–0.890) | 0.880 (0.858–0.902) |
0.825 (0.798–0.851) | 0.836 (0.809–0.862) |
0.857 (0.833–0.882) | 0.871 (0.848–0.895) |
Sepsis (n=630) | 0.843 (0.807–0.879) | 0.858 (0.824–0.892) |
0.893 (0.860–0.926) | 0.902 (0.870–0.933) |
0.842 (0.806–0.879) | 0.858 (0.823–0.893) |
Lactate ≥2 mmol/L (n=972) | 0.875 (0.854–0.896) | 0.887 (0.866–0.907) |
0.842 (0.818–0.867) | 0.852 (0.828–0.876) |
0.866 (0.844–0.889) | 0.879 (0.857–0.900) |
Lactate <2 mmol/L (n=550) | 0.847 (0.810–0.884) | 0.864 (0.829–0.899) |
0.888 (0.852–0.923) | 0.899 (0.866–0.932) |
0.847 (0.809–0.884) | 0.865 (0.829–0.901) |
SOFA score component | AUC (95% CI) | OR (95% CI) | P-value |
---|---|---|---|
Cardiovascular | 0.734 (0.710–0.757) | 1.35 (1.16–1.56) | <0.001 |
Pulmonary | 0.595 (0.567–0.623) | 1.09 (0.92–1.28) | 0.320 |
Neurological | 0.948 (0.935–0.960) | 4.82 (4.17–5.57) | <0.001 |
Renal | 0.561 (0.533–0.588) | 1.08 (0.93–1.26) | 0.280 |
Hematology | 0.584 (0.557–0.610) | 1.33 (1.11–1.59) | 0.002 |
Hepatology | 0.586 (0.559–0.612) | 1.05 (0.88–1.26) | 0.580 |
Values are presented as median (interquartile range), number (%), or mean±standard deviation. APACHE: Acute Physiology and Chronic Health Evaluation; SAPS: Simplified Acute Physiology Score; SOFA: Sequential Organ Failure Assessment; mSOFA: modified SOFA; ICU: intensive care unit; LOS: length of stay.
Values are presented as AUC (95% confidence interval). AUC: area under the receiver operating characteristic curve; SOFA: Sequential Organ Failure Assessment; mSOFA: modified SOFA; ICU: intensive care unit. Comparison between AUC of SOFA and mSOFA score: P<0.001 P<0.01, P<0.05, P>0.05.
AUC: area under the receiver operating characteristic curve; OR: odds ratio; SOFA: Sequential Organ Failure Assessment; CI: confidence interval.