Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients
Abstract
Context Evaluation of trends in organ dysfunction in critically ill patients may help predict outcome. Objective To determine the usefulness of repeated measurement the Sequential Organ Failure Assessment (SOFA) score for prediction of mortality in intensive care unit (ICU) patients. Design Prospective, observational cohort study conducted from April 1 to July 31, 1999. Setting A 31-bed medicosurgical ICU at a university hospital in Belgium. Patients Three hundred fifty-two consecutive patients (mean age, 59 years) admitted to the ICU for more than 24 hours for whom the SOFA score was calculated on admission and every 48 hours until discharge. Main outcome measures Initial SOFA score (0-24), Delta-SOFA scores (differences between subsequent scores), and the highest and mean SOFA scores obtained during the ICU stay and their correlations with mortality. Results The initial, highest, and mean SOFA scores correlated well with mortality. Initial and highest scores of more than 11 or mean scores of more than 5 corresponded to mortality of more than 80%. The predictive value of the mean score was independent of the length of ICU stay. In univariate analysis, mean and highest SOFA scores had the strongest correlation with mortality, followed by Delta-SOFA and initial SOFA scores. The area under the receiver operating characteristic curve was largest for highest scores (0.90; SE, 0.02; P 90%), a decreasing score during the first 48 hours was associated with a mortality rate of less t…
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Traditional severity scoring systems typically focus on mortality prediction rather than dynamic changes in patient recovery trajectories.
“Furthermore, these scoring systems typically focus on mortality prediction rather than the dynamic changes in patient recovery trajectories7,8.”
From Machine learning predicts sepsis deterioration trajectories. (2026) · cites this paper as [7]
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“Furthermore, these scoring systems typically focus on mortality prediction rather than the dynamic changes in patient recovery trajectories 7,8 .”
- Authors
- Ferreira, F. L.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2001-10-10
- Volume
- 286
- Issue
- 14
- Pages
- 1754
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1974873560
- Cited by
- 2,862
- References
- 1
- Citations by year
- 2026: 124 · 2025: 180 · 2024: 195 · 2023: 199 · 2022: 214 · 2021: 253 · 2020: 238 · 2019: 215 · 2018: 134 · 2017: 121 · 2016: 106 · 2015: 123 · 2014: 114 · 2013: 95 · 2012: 81
- FWCI
- 15.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- SOFA score, organ dysfunction, mortality prediction, intensive care unit patients, critically ill patients, prognostic scoring, ICU length of stay, mortality risk stratification
- MeSH terms
- Adult, Aged, Female, Humans, Intensive Care Units, Male, Middle Aged, Multiple Organ Failure, Prognosis, Prospective Studies, Severity of Illness Index, Survival Analysis, Critical Illness
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