Critical Care and Shock

Validation test of sequential organ failure assessment score in predicting 28-day mortality in critically ill COVID-19

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Abstract

Background: Mortality predictors are often used for analyzing disease progression as a guide for disease management strategy. The sequential organ failure assessment (SOFA) score is a predictor tool used to analyze organ dysfunction in critically ill patients. This study aimed to validate the SOFA score in predicting 28-day mortality in critically ill Coronavirus disease 2019 (COVID-19) patients.

Methods: Subjects included in this study were critically ill, confirmed COVID-19 cases admitted to the intensive care unit (ICU) between March and August 2020. Demographic data, clinical characteristics, and laboratory findings within the first 24 hours of ICU admission were obtained from medical records to compute the SOFA score. The 28-day outcome was recorded as alive or deceased. Validity was analyzed using the area under the curve (AUC), Hosmer-Lemeshow goodness of fit, and bivariate logistic regression. The optimal cut-off point was determined statistically.

Result: From the total of 88 subjects in this study, the mortality rate was 39.8%. AUC was 0.971 (confidence interval [CI] 95% 0.943-0.999), and the goodness of fit test by using Hosmer-Lemeshow showed p=0.782. An optimal cut-off point of SOFA score was 6, with a sensitivity of 87% and specificity of 90%.

Discussion: SOFA score demonstrated very strong discrimination and good calibration in predicting 28-day mortality on the critical case of COVID-19.

Conclusion: The SOFA score is valid for predicting 28-day mortality in the critical case of COVID-19.