Application of a modified sequential organ failure assessment score to critically ill patients.
The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Terapia Intensiva, Mexico City, Mexico. amendys@incan.edu.mx
S A
SA
Namendys-Silva
M A
MA
Silva-Medina
G M
GM
Vásquez-Barahona
J A
JA
Baltazar-Torres
E
E
Rivero-Sigarroa
J A
JA
Fonseca-Lazcano
G
G
Domínguez-Cherit
D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000145:classification* / Q000401:mortality; D063305:Organ Dysfunction Scores; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index