Sequential Organ Failure Assessment Score Modified for Recent Infection in Patients With Hematologic Malignant Tumors and Severe Sepsis.
Jared A Greenberg, Michael Z David, Matthew M Churpek and 3 others
PMID 27587420WHAT IT FOUND
In ICU patients with blood cancers and severe sepsis, adding recent infection points to the SOFA score predicted death better than standard SOFA and APACHE II.
Key findings
01The modified score separated survivors from non-survivors better than the standard SOFA score and APACHE II, with AUROC 0.73 versus 0.68 and 0.65.
02Each two-point increase in the recent-infection score was an independent risk factor for death.
03In the validation cohort, 105 patients (54%) died during the first 30 days after ICU admission.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was retrospective and single-center, so results may not apply elsewhere. The score was built from a small derivation group and tested in a validation group from the same hospital. It depends on finding and timing prior infections in records, which may be hard to automate. The authors say it may not perform better in centers with less prior infection exposure. The study did not test whether using the score changes care.
Declared interests
The authors declared no conflicts of interest. The supplied publication types indicate NIH extramural research support.
The easy way to misread this
Do not treat the modified score as ready for general ICU use. It was built and tested in a small, single-center cohort, and the authors note it may not be more accurate in settings with less prior infection exposure.