SOFA Score on Presentation to Emergency Department in Predicting in-Hospital Mortality of Patients with Sepsis

Background: Sequential Organ Failure Assessment score (SOFA) is an objective tool to describe individual and aggregate organ dysfunction in critically ill patients. The aim of the study was to determine the diagnostic utility of Admission time SOFA score calculated at the Emergency Department (ED) in predicting in-hospital mortality of patients with suspected sepsis. Materials and methods: Patients aged 18 years or above with clinical features of infection and satisfying two or more q SOFA criteria were enrolled into the study. On arrival to the emergency department, patients were assessed and resuscitated as per the institutional sepsis protocol. Clinical and laboratory parameters required to calculate the SOFA score were collected and documented at the ED. Patients are then followed up to the clinical end point as defined as Survival to hospital discharge or Death. Receiver Operating Curve (ROC) analysis was done to determine the discriminative ability of admission time SOFA score to predict in-hospital mortality. Results: A total of 182 patients were included in the study. Of this 111 patients (61%) died and 71 patients (39%) survived to hospital discharge. The mean SOFA score of patients who died during the hospital stay was 12.9 (SD=2.8) and that of patients who survived to hospital discharge was 9.2 (SD=3%) and the difference was statistically significant with a p-value of <0.01. ROC analysis revealed that at the optimal cut off value of 10.5, SOFA score on admission carried a sensitivity of 85.6%, Specificity of 62% and accuracy of 76.4% in predicting in-hospital mortality. Conclusions: SOFA score calculated on admission at the Emergency department is a useful tool to predict in-hospital mortality of patients with sepsis.