Accuracy of SOFA Score to Predict Outcome in Community- Acquired Sepsis

Chutima Cheranakhorn MD¹, Thanva Teeratpatcharakun MD¹

Affiliation : ¹ Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand

Background : The new definition of Sepsis-3 defines sepsis as life-threatening organ dysfunction, demonstrated by an increase in the Sequential Organ Failure Assessment (SOFA) of 2 or more points, caused by a dysregulated host response to infection. The performance of SOFA score data in a setting of a tertiary public hospital in a middle-income country remains limited.
Objective : To determine the accuracy of the SOFA score to predict the 28-day mortality in community-acquired sepsis patients. Materials and Methods : A retrospective study enrolled community-acquired sepsis and septic shock patients admitted between January and December 2015 in Hatyai Hospital, a tertiary public Hospital in Southern Thailand. All variables for calculating the SOFA and qSOFA scores were collected. The primary outcome was the 28-day mortality.
Results : Three hundred seventy-nine patients were enrolled. Eighty-seven patients (23%) died. The median (IQR) SOFA score was 6 (3, 9) points. The SOFA score had a fair predictive performance (AUROC 0.71, 95% CI 0.65 to 0.77), which was higher than qSOFA score (AUROC 0.67, 95% CI 0.62 to 0.73). The SOFA score of 2 points associated with mortality (13%) and higher score patients had an incremental increase mortality rate. The hazard ratio (HR) was 4.59 (95% Cl 1.3 to 15.78, p=0.02) for SOFA Score 6 to 7 points.
Conclusion : Among patients presenting with community-acquired infection, the SOFA score indicated the fair predicting ability for the 28-day mortality and performed better than qSOFA score.

Received 31 May 2020 | Revised 30 September 2020 | Accepted 30 September 2020
doi.org/10.35755/jmedassocthai.2021.04.11555

Keywords : SOFA, qSOFA, Sepsis, Accuracy, Mortality, Community-acquired infection, Thailand

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