title: Serial evaluation of SOFA score in a Brazilian teaching hospital.
abstract: OBJECTIVE
  To evaluate the application of the Sequential Organ Failure Assessment (SOFA) in describing the severity of organ dysfunctions and the associated mortality rates in critically ill patients at a teaching hospital.
  
  
  METHODS
  Prospective longitudinal study performed in 1164 adult, critically ill patients who were admitted consecutively into intensive care units between January 2004 and December 2005. We analysed static evaluation of SOFA and dynamic changes in the SOFA scores. The discriminative power of SOFA was evaluated using ROC curves.
  
  
  RESULTS
  There was an increase in the mortality rate when the SOFA scores increased (chi2(trend)=272.08, p<0.001, increase rate=0.13). The SOFA score on the third day in the ICU had the highest area under the curve for hospital mortality (AUC: 0.817+/-0.0133, CI 95%: 0.792-0.840). We analysed SOFA score changes with time and observed that patients with low scores (0-5) upon admission and who increased to the medium or high SOFA groups had a significantly higher mortality rate (51.7 and 100%, respectively, p<0.001).
  
  
  CONCLUSIONS
  Applying SOFA to critically ill patients effectively described the severity of organ dysfunctions, and higher SOFA scores had a positive association with mortality.
authors.affiliation: Registered Nurse Intensive Care Unit, Londrina University Hospital, Londrina, Paraná, Brazil.
authors.forename: Elza H T
authors.initials: EH
authors.lastname: Anami
authors.forename: Cintia M C
authors.initials: CM
authors.lastname: Grion
authors.forename: Lucienne T Q
authors.initials: LT
authors.lastname: Cardoso
authors.forename: Ivanil A M
authors.initials: IA
authors.lastname: Kauss
authors.forename: Maria C
authors.initials: MC
authors.lastname: Thomazini
authors.forename: Hugo B
authors.initials: HB
authors.lastname: Zampa
authors.forename: Ana M
authors.initials: AM
authors.lastname: Bonametti
authors.forename: Tiemi
authors.initials: T
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000401:mortality; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index