0
Clinical Investigations in Critical Care |

Application of the Sequential Organ Failure Assessment Score to Cardiac Surgical Patients*

Roberto Ceriani; Maurizio Mazzoni; Franco Bortone; Sara Gandini; Costantino Solinas; Giuseppe Susini; Oberdan Parodi
Author and Funding Information

*From the Department of Anesthesia and ICU (Drs. Ceriani, Mazzoni, Bortone, and Solinas), Humanitas Gavazzeni, Bergamo; the Division of Epidemiology and Biostatistics (Dr. Gandini) and Department of Anesthesia and ICU (Dr. Susini), European Institute of Oncology, Milano; and Section of Milano (Dr. Parodi), CNR Clinical Physiology Institute, Niguarda Ca’ Granda Hospital, Milano, Italy.

Correspondence to: Maurizio Mazzoni, MD, Anestesia e Terapia Intensiva, Humanitas Gavazzeni, Via Mauro Gavazzeni 21, 24125 Bergamo, Italy; e-mail: maurizio.mazzoni@gavazzeni.it



Chest. 2003;123(4):1229-1239. doi:10.1378/chest.123.4.1229
Text Size: A A A
Published online

Objective: To assess the applicability of the sequential organ failure assessment (SOFA) score to cardiac surgical patients.

Design: Observational cohort study.

Setting: Adult cardiac surgical ICU.

Patients: Two hundred eighteen patients requiring ICU stay > 96 h.

Measurements and results: The SOFA score was calculated daily until ICU discharge. Derived SOFA variables—total maximum SOFA (TMS), ΔSOFA, maximum SOFA (maxSOFA), and ΔmaxSOFA—were considered. Length of ICU stay was 8.9 ± 6.7 days (mean ± SD). The mortality rate was 11.0% in the ICU and 15.6% in the hospital. Nonsurvivors had higher TMS, ΔSOFA, single-organ system, and mean total scores on day 1 (9.8 ± 2.5 vs 7.8 ± 2.3, p < 0.05) and thereafter until day 10. The total SOFA score on the first 10 days of ICU stay, time, survival status, and their interaction were all significant (p < 0.001), with higher SOFA scores for nonsurvivors, and lower scores for survivors that decreased as the number of days from operation increased. Cardiovascular score on day 1 carried the highest relative risk of mortality among other systems (risk ratio [RR], 2.12; 95% confidence interval [CI], 1.31 to 3.45; p < 0.01), as did maximum cardiovascular score (RR, 2.81; 95% CI, 1.62 to 4.85; p < 0.001). A growing number of failing organs was associated with mortality, from the first to the sixth postoperative day (p < 0.05). Total score on day 1, TMS, ΔSOFA, maxSOFA, and ΔmaxSOFA were reliable predictors of mortality with area under receiver operating characteristic curve of 0.71 (SE, 0.08), 0.89 (SE, 0.05), 0.86 (SE, 0.06), 0.88 (SE, 0.05), and 0.88 (SE, 0.06), respectively. Length of hospital stay was significantly associated (p = 0.05) to TMS and ΔSOFA and not to other SOFA scores, age, or sex.

Conclusions: The SOFA score may be used to grade the severity of postoperative morbidity in cardiac surgical patients without specific adaptations. The model identifies patients at increased risk for postoperative mortality.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543