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VOLUME 26 , ISSUE 4 ( April, 2022 ) > List of Articles

Original Article

Comparison of Sequential Organ Failure Assessment Score and Sequential Organ Failure Assessment Score with pH in Outcome Prediction among ICU Patients: A Prospective Observational Study

Atiharsh M Agarwal, Amrita Gupta, Avanish K Saxena, Radhika Sahni, Aviral Pandey

Keywords : pH, Respiratory acidosis, Scoring system, SOFA score

Citation Information : Agarwal AM, Gupta A, Saxena AK, Sahni R, Pandey A. Comparison of Sequential Organ Failure Assessment Score and Sequential Organ Failure Assessment Score with pH in Outcome Prediction among ICU Patients: A Prospective Observational Study. Indian J Crit Care Med 2022; 26 (4):479-483.

DOI: 10.5005/jp-journals-10071-24165

License: CC BY-NC 4.0

Published Online: 13-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: To examine if sequential organ failure assessment (SOFA) alone or SOFA in combination with pH is a better prognosis and mortality indicator. Materials and methods: We conducted a prospective observational study in a total of sixty patients. The mortality of patients was predicted on the basis of a SOFA score alone or SOFA score in combination with pH, and the prediction by both was compared to the actual outcome. The comparison was based on the “standardized mortality ratio” and the “area under the receiver operating characteristic curve (AUROC).” Result: At the time of admission, both the scores (SOFA and SOFA with pH) were equally effective in predicting mortality. At 48 hours, SOFA with pH proves to be slightly better in mortality prediction than SOFA score alone. The discriminative power of both the scores was assessed by calculating AUROC. AUROC of the SOFA score was better than that of SOFA with pH at admission and at 48 hours, but statistically, both had the same level of discrimination, i.e., excellent. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were the same for both the scores at admission, but all parameters except specificity were better for SOFA with pH at 48 hours. Specificity was the same for both even at 48 hours. Conclusion: At the time of admission, SOFA score and SOFA with pH were equally effective in outcome prediction, but after 48 hours, SOFA with pH proves to be better than the SOFA score alone. The power of discrimination is the same for both the scores at admission and at 48 hours.

  1. Vincent JL, Gustot T. Sepsis and cirrhosis: many similarities. Acta Gastroenteral Belg 2010;73(4):472–478. PMID: 21299157.
  2. Sinuff T, Adhikari NK, Cook DJ, Schünemann HJ, Griffith LE, Rocker G, et al. Mortality predictions in the intensive care unit: comparing physicians with scoring systems. Crit Care Med 2006;34(3):878–885. DOI: 10.1097/01.CCM.0000201881.58644.41.
  3. Le Gall JR. The use of severity scores in the intensive care unit. Intensive Care Med 2005;31(12):1618–1623. DOI: 10.1007/s00134-005- 2825-8.
  4. Moreno R, Vincent JL, Matos R, Mendonca A, Cantraine F, Thijs L, et al. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Intensive Care Med 1999;25(7):686–696. DOI: 10.1007/s001340050931.
  5. Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. Journal of the American Medical Association 2001;286(14):1754–1758. DOI: 10.1001/jama.286.14.1754.
  6. Watson ML. Back to basics: acid-base disorders. Can J CME 2002;14(6):57.
  7. Singh V, Khatana S, Gupta P. Blood gas analysis for bedside diagnosis. Natl J Maxillofac Surg 2013;4(2). DOI: 10.4103/0975-5950.127641.
  8. Khwannimit B. Serial evaluation of the MODS, SOFA and LOD scores to predict ICU mortality in mixed critically ill patients. J Med Assoc Thai 2008;91(9):1336–1342. PMID: 18843861.
  9. Rajawat MS, Rathore SS, Choudhary M. pH disorders and mortality in surgical intensive care unit patients. Int Surg J 2016;3(2):905–907. DOI: 10.18203/2349-2902.ISJ20161165.
  10. Bale C, Kakrani AL, Dabadghao VS, Sharma ZD. Sequential organ failure assessment score as prognostic marker in critically ill patients in a tertiary care intensive care unit. Int J Med Public Health 2013;3(3):155. DOI: 10.4103/2230-8598.118956.
  11. Frantz TL, Gaski GE, Terry C, Steenburg SD, Zarzaur BL, McKinley TO. The effect of pH versus base deficit on organ failure in trauma patients. J Surg Res 2016;200(1):260–265. DOI: 10.1016/j.jss.2015.07.003.
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