EVALUATION OF SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE IN PREDICTING SURVIVAL IN SYSTEMIC INFLAMMATORY RESPONSE SYNDROME PATIENTS IN PAEDIATRIC INTENSIVE CARE UNIT

Dr. Nisha Aglave; Dr. Abhimannyu Niswade

Volume : IX, Issue : IV, April - 2020

EVALUATION OF SEQUENTIAL ORGAN FAILURE ASSESSMENT SCORE IN PREDICTING SURVIVAL IN SYSTEMIC INFLAMMATORY RESPONSE SYNDROME PATIENTS IN PAEDIATRIC INTENSIVE CARE UNIT

Dr. Nisha Aglave, Dr. Abhimannyu Niswade

Abstract :

Background: Various scoring systems have been developed to prioritize patient admission and management in PICU. The objective of this prospective, observational, longitudinal study was to evaluate application of one such system, the Sequential Organ Failure Assessment (SOFA) Score in predicting outcome in ICU patients with SIRS. Methods: Hundred patients satisfying the SIRS criteria and additionally satisfying inclusion criteria serially admitted to Pediatric ICU 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: Analyzing the SOFA scores, when Initial SOFA, Mean SOFA, Highest SOFA, and Delta SOFA scores were compared to outcome, the non survivors had high initial, mean and highest SOFA scores and delta SOFA as compared to survivors (p value = 0.0011, 0.0000, 0.0000, 0.0000) respectively. The initial (Day 1) SOFA score > 11 predicted a mortality of 92.8%. (Chi–square for trend= 10.65). Similarly, mean SOFA score of > 7 predicted a mortality of 97.78% ( Chi–square for trend= 71.61) and highest SOFA score > 11 predicted a mortality of 80.65% (Chi–square for trend= 46.37) also, the Delta SOFA score ≥8 predicted the mortality of 100% (Chi–square for trend=7.985). All these values were compared with PRISM score which was calculated at the time of admission. The PRISM score ≥8 predicted mortality of 93.7%( Chi–square for trend=39.43). Area under receiver operating characteristic (ROC) curve for mean SOFA was 0.9651, for highest SOFA was 0.9482, for initial SOFA was 0.8178,for Delta SOFA was 0.671 and for PRISM was 0.8721. 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. The predictive value of PRISM III is better as compared to initial SOFA score.