title: The sequential organ failure assessment score predicts 30-day mortality in a geriatric acute care setting.
abstract: BACKGROUND
  Several tools to predict patients' survival have been proposed in medical wards, though they are often time consuming and difficult to apply. The Sequential Organ Failure Assessment (SOFA) is a promising tool that has been validated in intensive care units but never in acute medical wards. The aim of this study was to assess whether the SOFA score predicts short-term (30 days) mortality in a population of elderly patients admitted to a geriatric ward.
  
  
  METHODS
  This prospective observational cohort study was carried out in a Geriatric Clinic of an Italian teaching hospital. Among 359 patients consecutively and firstly admitted between January and April 2012, we considered eligible those (n = 314) directly admitted from the emergency department. Demographic, functional, and clinical variables were collected. The SOFA score was measured on admission (SOFA-admission) and 48 hours later (SOFA-48h). The vital status of participants was assessed over the 30 days following discharge.
  
  
  RESULTS
  Patients who died at 1-month follow-up were prevalently men, more comorbid, disabled, and undernourished and had higher SOFA scores on admission and at 48 hours than their counterparts. Among all potential predictors of 1-month mortality, the SOFA-48h score was the best, with a score greater than 4 significantly increasing the risk to die during hospitalization or in the 30 days following discharge (odds ratio = 7.030; 95% confidence interval = 3.982-12.409).
  
  
  CONCLUSIONS
  The SOFA score, a user-friendly tool used in intensive care units to estimate prognosis, is able to predict 1-month mortality also in patients admitted to an acute geriatric setting.
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, Milan, Italy. giuseppe.bellelli@unimib.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzola
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.forename: Sabrina
authors.initials: S
authors.lastname: Perego
authors.forename: Antonella
authors.initials: A
authors.lastname: Zambon
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazzone
authors.forename: Adriana A
authors.initials: AA
authors.lastname: Bruni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Annoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D007558:Italy / Q000453:epidemiology; D008297:Male; D009102:Multiple Organ Failure / Q000401:mortality*; D063305:Organ Dysfunction Scores; D011446:Prospective Studies; D012307:Risk Factors
keywords: Frailty; Geriatric assessment; Hospital related; Morbidity; Multimorbidities; Outcomes.