SOFA SCORE FOR PREDICTING OUTCOME OF SEVERE FALCIPARUM MALARIA

Plasmodium falciparum malaria is a serious cause of morbidity and mortality. The System Organ Failure Assessment (SOFA) score was developed 20 years ago to predict outcome of severely illness patients. We aimed to assess the efficacy of SOFA score for discriminating between patients with severe and non-severe malaria; and fatal and non-fatal malaria in order to determine the usefulness of the SOFA score as a predictive tool for future patients with P. falciparum malaria infection. We retrospectively reviewed the medical records of P. falciparum malaria patients presenting to the Bangkok Hospital for Tropical Diseases, Thailand during 2005-2015. Inclusion criteria were patients aged >= 15 years with P. falciparum malaria mono-infection. Exclusion criteria were pregnant and lactating women or patients with missing medical records. Descriptive statistics were used to summarize baseline values and demographic data. Chi-square (chi(2)) or Fisher's exact tests were used to compare proportions when appropriate. Sensitivity and specificity were calculated for score performance. A total of 642 subjects were studied, of whom 287 had severe malaria and there were 2 deaths (mortality rate=0.3%). A cut-off value of 0 could discriminate severe disease with sensitivity and specificity of 97.2% and 13.5%, respectively; and a cut-off value of 10 could discriminate mortality with sensitivity and specificity of 100% and 97.9%, respectively. In conclusion, SOFA score may be useful to discriminate severe disease and mortality in patients with P. falciparum malaria. However, since this study was retrospective, further prospective study is needed to determine if it is really useful in malaria patients in other hospitals.