Application of “the Sequential Organ Failure Assessment (SOFA)
score” in predicting outcome in ICU patients with SIRS
Acharya SP1, Pradhan B2, Marhatta MN3
1Lecturer, 2Asstant Professor, 3Associate Professor and Head, Department of Anesthesiology, Tribhuban University
Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Background: Various scoring systems have been developed to prioritize patient admission and management in ICU.
The objective of this prospective, observational cohort study was to evaluate application of one such system, the
Sequential Organ Failure Assessment (SOFA) Score in predicting outcome in ICU patients with SIRS. Patients and
Methods: Fifty patients admitted to a six bed multidisciplinary ICU with SIRS were consecutively enrolled in the
study and SOFA scores were calculated at zero hour, after 48 hrs, and after 96 hrs and patients followed till
discharge from hospital.
Results: When compared to outcome, the non survivors had high initial, mean and highest SOFA scores as
compared to survivors. (p value = 0.002, <0.001, <0.001 respectively). Delta SOFA was not significantly associated
with outcome. (p value= 0.117). The initial SOFA score > 11 predicted a mortality of 90%. (OR 23.72, 95%CI2.68-
209.78, p=0.004). Similarly, mean SOFA score of > 7 predicted a mortality of 73.9% (OR 22.7, 95%CI 5.0 – 103.5,
p<0.001) and high SOFA score > 11 predicted a mortality of 87.5% (OR 32.66, 95%CI 5.82-183.179, p< 0.001).
Area under receiver operating characteristic (ROC) curve for mean SOFA was 0.825, for high SOFA was 0.817 and
for initial SOFA was 0.708. Thus mean, high and initial SOFA scores were helpful in predicting between the
survivors and the non survivors.
Conclusion: The SOFA scoring system is useful in predicting outcomes in ICU and thus help in proper utilization
of ICU resources.
Key words: Sequential Organ Failure Assessment (SOFA) Score, Systemic Inflammatory Response Syndrome
(SIRS), Intensive Care Unit (ICU).