title: Discriminative power on mortality of a modified Sequential Organ Failure Assessment score for complete automatic computation in an operative intensive care unit.
abstract: OBJECTIVE
  To evaluate the discriminative power on mortality of a modified Sequential Organ Failure Assessment (SOFA) score and derived measures (maximum SOFA, total maximum SOFA, and delta SOFA) for complete automatic computation in an operative intensive care unit (ICU).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Operative ICU of the Department of Anesthesiology and Intensive Care Medicine.
  
  
  METHODS
  Patients admitted to the ICU from April 1, 1999, to March 31, 2000 (n = 524). Data from patients under the age of 18 yrs and patients who stayed <24 hrs were excluded. In the case of patient readmittance, only data from the patient's last stay was included in the study.
  
  
  METHODS
  None.
  
  
  RESULTS
  The main outcome measure was survival status at ICU discharge. Based on Structured Query Language (SQL) scripts, a modified SOFA score for all patients who stayed in the ICU in 1 yr was calculated for each day in the ICU. Only routine data were used, which were supplied by the patient data management system. Score evaluation was modified in registering unavailable data as being not pathologic and in using a surrogate of the Glasgow Coma Scale. During the first 24 hrs, 459 survivors had an average SOFA score of 4.5 +/- 2.1, whereas the 65 deceased patients averaged 7.6 +/- 2.9 points. The area under the receiver operating characteristic (ROC) curve was 0.799 and significantly >0.5 (p <.01). A confidence interval (CI) of 95% covers the area (0.739-0.858). The maximum SOFA presented an area under the ROC of 0.922 (CI: 0.879-0.966), the total maximum SOFA of 0.921 (CI: 0.882-0.960), and the delta SOFA of 0.828 (CI: 0.763-0.893).
  
  
  CONCLUSIONS
  Despite a number of differences between completely automated data sampling of SOFA score values and manual evaluation, the technique used in this study seems to be suitable for prognosis of the mortality rate during a patient's stay at an operative ICU.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen, Giessen, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Junger
authors.forename: Jörg
authors.initials: J
authors.lastname: Engel
authors.forename: Matthias
authors.initials: M
authors.lastname: Benson
authors.forename: Sebastian
authors.initials: S
authors.lastname: Böttger
authors.forename: Caroline
authors.initials: C
authors.lastname: Grabow
authors.forename: Bernd
authors.initials: B
authors.lastname: Hartmann
authors.forename: Achim
authors.initials: A
authors.lastname: Michel
authors.forename: Rainer
authors.initials: R
authors.lastname: Röhrig
authors.forename: Kurt
authors.initials: K
authors.lastname: Marquardt
authors.forename: Gunter
authors.initials: G
authors.lastname: Hempelmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000401:mortality; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate