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Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patientsopen accessModified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients

Other Titles
Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients
Authors
Ko, Byuk SungRyoo, Seung MokHan, EunahChang, HyunglanYune, Chang JuneLee, Hui JaiSuh, Gil JoonChoi, Sung-HyukChung, Sung PhilLim, Tae HoKim, Won YoungSohn, Jang WonJeong, Mi AeHwang, Sung YeonShin, Tae GunKim, Kyuseok
Issue Date
Dec-2023
Publisher
대한의학회
Keywords
Sepsis; Mortality; Organ Dysfunction Scores; Severity of Illness Index
Citation
Journal of Korean Medical Science, v.38, no.50, pp 1 - 12
Pages
12
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Korean Medical Science
Volume
38
Number
50
Start Page
1
End Page
12
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/66625
DOI
10.3346/jkms.2023.38.e418
ISSN
1011-8934
1598-6357
Abstract
Background: There is a need to update the cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score to reflect the current practice in sepsis. We previously proposed the modified CV SOFA score from data on blood pressure, norepinephrine equivalent dose, and lactate as gathered from emergency departments. In this study, we externally validated the modified CV SOFA score in multicenter intensive care unit (ICU) patients.Methods: A multicenter retrospective observational study was conducted on ICU patients at six hospitals in Korea. We included adult patients with sepsis who were admitted to ICUs. We compared the prognostic performance of the modified CV/total SOFA score and the original CV/total SOFA score in predicting 28-day mortality. Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and the calibration curve, respectively.Results: We analyzed 1,015 ICU patients with sepsis. In overall patients, the 28-day mortality rate was 31.2%. The predictive validity of the modified CV SOFA (AUROC, 0.712; 95% confidence interval [CI], 0.677-0.746; P < 0.001) was significantly higher than that of the original CV SOFA (AUROC, 0.644; 95% CI, 0.611-0.677). The predictive validity of modified total SOFA score for 28-day mortality was significantly higher than that of the original total SOFA (AUROC, 0.747 vs. 0.730; 95% CI, 0.715-0.779; P = 0.002). The calibration curve of the original CV SOFA for 28-day mortality showed poor calibration. In contrast, the calibration curve of the modified CV SOFA for 28-day mortality showed good calibration.Conclusion: In patients with sepsis in the ICU, the modified SOFA score performed better than the original SOFA score in predicting 28-day mortality.
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Choi, Sung Hyuk
Guro Hospital (Department of Emergency Medicine, Guro Hospital)
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