SOFA Score Lit Review
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SOFA Mortality Charts for Various Patient Populations
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Contributors: Katie Lichter, Pragna Shetty, Emma Ghazaryan, Mary Ann Hernando, Tyler Adamson, Viraj Ambalam
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Article TitlePatient Population Studied (n)Mortality DataNotes/Additional GraphsReference
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PrognosticAccuracy of theSOFAScore, SIRS Criteria, andqSOFAScore for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care UnitICU Patients With Suspected Infection (N = 184 875)
https://jamanetwork-com.proxy1.library.jhu.edu/journals/jama/fullarticle/2598267
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Predictive Value of the Sequential Organ Failure Assessment Score
for Mortality in a Contemporary Cardiac Intensive Care Unit
Population
CICU Patients
https://www.ahajournals.org/doi/pdf/10.1161/JAHA.117.008169
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Predictive value of individual Sequential Organ Failure Assessment sub-scores for mortality in the cardiac intensive care unit.CICU Patients (n = 1214)
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/31107889
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Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill PatientsICU Patients (in Belgium)
https://jamanetwork.com/journals/jama/fullarticle/194262
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Predictors of survival in patients with sarcoma admitted to the intensive care unitSarcoma ICU Patients
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pmc/articles/PMC4950117/
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Low Energy Intake During the First Week in an Emergency Intensive Care Unit Is Associated With Reduced Duration of Mechanical Ventilation in Critically Ill Underweight Patients: A Single-Center Retrospective Chart ReviewCritically Ill Underweight Patients
https://onlinelibrary-wiley-com.proxy1.library.jhu.edu/doi/full/10.1111/ctr.12486
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Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency DepartmentSeptic Patients in the ED
https://www-sciencedirect-com.proxy1.library.jhu.edu/science/article/pii/S0735675718308891?via%3Dihub#f0010
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Serial evaluation of SOFA score in a Brazilian teaching hospital
Critically Ill ICU patients (n= 1164)
https://www-sciencedirect-com.proxy1.library.jhu.edu/science/article/pii/S0964339709001049`
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Sepsis Clinical Criteria in Emergency Department Patients Admitted to an Intensive Care Unit: An External Validation Study of Quick Sequential Organ Failure Assessment.Septic ED Patients admitted to the ICU
https://www-sciencedirect-com.proxy1.library.jhu.edu/science/article/pii/S0736467916308873?via%3Dihub
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The Sequential Organ Failure Assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentationED patients with severe sepsis with evidence of hypoperfusion (n = 248)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2703722/
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Severe acute pancreatitis admitted to intensive care unit: SOFA is superior to Ranson's criteria and APACHE II in determining prognosis.ICU patients with severe acute pancreatitis (n=39)
"All patients with an initial SOFA score ≥7 died (64% sensitivity, 65% specificity, ROC=0,697). In addition, if SOFA score was ≥11 at any time during ICU stay, mortality was higher (80% sensitivity, 79% specificity, ROC=0,837)."https://www.researchgate.net/publication/260372042_Severe_acute_pancreatitis_admitted_to_intensive_care_unit_SOFA_is_superior_to_Ranson's_criteria_and_APACHE_II_in_determining_prognosi
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Multiple Organ System Failure in Critically Ill Cirrhotic PatientsPatients diagnosed with liver cirrhosis admitted to the MICU (n = 160)
https://www.researchgate.net/publication/240085115_Multiple_Organ_System_Failure_in_Critically_Ill_Cirrhotic_Patients
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Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: a multinational multicenter prospective observational studyHospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia (n = 3), Thailand (n = 3), and Vietnam (n = 3)
https://jintensivecare.biomedcentral.com/track/pdf/10.1186/s40560-018-0279-7
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Assessment and comparison of APACHE II (Acute Physiology and Chronic Health Evaluation), SOFA (Sequential Organ Failure Assessment) score and CURB 65 (Confusion; Urea; Respiratory Rate; Blood Pressure), for prediction of inpatient mortality in Acute Exacerbation of Chronic Obstructive Pulmonary DiseasePatients with acute exacerbation of COPD at the Jinnah Post-Graduate Medical Centre, Karachi (n=95)
"The AUC of CURB-65, APACHE II and SOFA was
0.78, 0.76 and 0.66 respectively for the prediction
of ICU mortality... Although SOFA exhibited statistically significant differences in scores among survivors and non-survivors in the present study, its discriminatory power as predictor of in-patient mortality was shown to be much less when compared to the other
two scoring systems."
https://jpma.org.pk/article-details/9039?article_id=9039
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Efficacy and accuracy of qSOFA and SOFA scores as prognostic tools for community-acquired and healthcare-associated pneumonia.Patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) who were admitted to the study institution in Japan (n = 406)
https://www-clinicalkey-com.proxy1.library.jhu.edu/#!/content/playContent/1-s2.0-S1201971219301900?returnurl=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1201971219301900%3Fshowall%3Dtrue&referrer=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2F
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Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis.Patients with acute severe pancreatitis (n = 159)
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pmc/articles/PMC5839831/figure/F1/
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Epidemiology and outcome analysis of sepsis and organ dysfunction/failure after burnsAdult patients (age 20 years) admitted in the ICU, with major and moderate burns (n = 346)
https://pdf.sciencedirectassets.com/271327/1-s2.0-S0305417916X00150/1-s2.0-S0305417917301365/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEPP%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIG4EX0ctu5jes6dKCWVzDK9gO4jBUF2q2rJj7%2BQaXreoAiBfpXNGahuTDzC0utFk2KAEvDeRn%2Fi9%2FUnBYYdTSs9KmSq9Awjc%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAIaDDA1OTAwMzU0Njg2NSIMKCdtV10ZE%2BHDx%2Bd5KpEDBk4b9WtclxMj52KDt3bt5FjVDzQtImAGSEXmaBgnJKRlEUKz7Z%2FSapA9KhD4YD1PzBBQw6icEU2OzmVWJCB0SPqgsHUifg%2F5w%2FSX3el%2BYBtSaZKjrT0wKVGWsMrjNtfcIZ%2B523%2FkXQwLgn%2BGiv%2Fhy%2F9a%2BSa3CJiw5%2F%2FL8U3Dx3Lq78Bl2aILTPl91TYVVss1zRwyomE79m8uhg%2B0rZ86tqXdnbNLZgQORVZ7C0ZY84%2BXj9JFdSUnv1xJrhn66%2FYa1YSrURUsm5p7JdZuaIDvKMVyr7Alez5IkmXMVlaTGKuaEtPC7nwsDHuSXjA4G57sHULcV2gK8Dp6fQUaFLQGc71ZSD30hCwK%2FQAbmnQwUbE%2B6LGU22Fz2ZmL3aUqJPl6yO%2BrUnIjelj%2BUbp4wKB7J5Y0HQMMfXi8w7uzpRemWrl7MG7YkWKZ%2BMoK5N8zZPdU1xdU4bsFY6otDoj5p2%2F7wzEyGroISpX8olw0onn722LulRFPBo7jd4tAjh8I2mw3pHKWNBBiQdFx3QVhADJfdokw%2BPzO8wU67AF7TD4iiAhGcngRy38SFBK%2BlTja8Y%2BiirTKcSdo1pE6sY%2FFOt7QssuCASfkqUruxXjH3ELoMzuO8kO36Otj9RcAa%2BWXTnanJgeaORDbBkPNQiImgjJBshBHxI70659iCufiXMlY1bmpV8NTqlzyMhs8r4Y2sZwStRqgF6uanQz7SWMhCygWvK%2FZXn6v92n3hJ6q1YQzWgtWuqM4SgxDgUmm%2Fuj1GEDarrWaL0wIdrVMfYBL%2FYeJsN7MW16oiuX9lnDo9qgME6I%2F9TMTN4gUTtYZAT0a2j5WWJ%2B4WlG97Wbt0P43k8Lud%2BvxMVIHNA%3D%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20200319T192650Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYUSCKKZ3S%2F20200319%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=3f564c62f64d118dd252ca4091cdf8bcb48af900253abfd1f5e1269639a7a6ab&hash=98650425a443c1be164d957dafb318936fe83d31386b2163bf8d5b42726ece2a&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S0305417917301365&tid=spdf-d8a51958-51f4-4391-843f-f00ab5a5fd3b&sid=6300ed455628c0423b1ac7e0845b3ebae8ccgxrqa&type=client
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The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)
patients of 80 years of age or older and admitted to the ICU were eligible (n=5021)
"Patients dying within 24 h had very high SOFA score, and withholding or withdrawal of therapy was frequent ". "Frail patients were older, had higher SOFA score, were more often female, and more frequently therapy was withheld or withdrawn." Hazard rate: "SOFA score
One-point increase 1.13 (1.12–1.14) < 0.001"
https://link-springer-com.proxy1.library.jhu.edu/article/10.1007/s00134-017-4940-8
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Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting
>20 years of age, who received isolated CABG. (n=483)
https://bmcsurg-biomedcentral-com.proxy1.library.jhu.edu/articles/10.1186/s12893-017-0219-9
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Acute Kidney Injury Enhances Outcome Prediction Ability of Sequential Organ Failure Assessment Score in Critically Ill Patients
Adult patients admitted to the ICU. Patients under 18 years of age, with organ transplant and end-stage renal disease (ESRD) with long-term dialysis were excluded (n=543)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109649
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qSOFA score: Predictive validity in Enterobacteriaceae bloodstream infections.
all patients age ≥ 18 with sepsis, severe sepsis, or septic shock (as defined by systemic inflammatory response syndrome (SIRS) criteria) and a positive blood culture for an organism in the Enterobacteriaceae family. (n=510)
"As qSOFA score increased from 0 to 3, patients were significantly more likely to require mechanical ventilation and have pneumonia as their source of infection, have CHF or COPD, have higher APACHE-II scores and lactate levels, were more likely to have severe sepsis or septic shock (by SIRS criteria), and less likely to have leukemia or sepsis (by SIRS criteria). Patients with a qSOFA score ≥ 2 had longer lengths of stay (LOS) and intensive care unit (ICU) LOS, and thirty day all-cause mortality than patients with a score < 2 "
https://www-sciencedirect-com.proxy1.library.jhu.edu/science/article/pii/S0883944117302952?via%3Dihub#f0005
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zAdult ICU patients with cirrhosis: 353 patients (69.5%) were admitted to medical ICU (MICU), and the other 155 (30.5%), to surgical unit
"Among 353 medical admissions, both MELD and SOFA were found to be significantly associated with 28-day mortality: MELD: odds ratio (OR) per point, 1.09; 95% confidence interval (CI), 1.05 to 1.13; P < .001; SOFA: OR per point, 1.17; 95% CI, 1.09 to 1.26; P < .001. "
https://www-sciencedirect-com.proxy1.library.jhu.edu/science/article/pii/S0883944114002147?via%3Dihub
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Intensive care unit acquired infection and organ failure.
Adults(>18 years) who stayed longer than 48 h in the ICU. (n=1191)
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/18259728
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Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapyall ICU patients, age 15 year who had AKI and were treated with RRT during the period 2004–07 at the Ghent University Hospital ICU and who were included in the electronic ICU patient database management system.
https://www.ncbi.nlm.nih.gov/pubmed/21421593
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Acinetobacter etiology respiratory tract infections associated with mechanical ventilation: what impacts on the prognosis? A retrospective cohort study.
all patients who were mechanically ventilated for >48 h and who developed culture-positive Acinetobacter in endotracheal aspirates (ETA) or bronchoalveolar lavage (BAL) in the adult ICU of the Hospital Nossa Senhora da Conceição, an 800-bed tertiary hospital located in Porto Alegre, Brazil, from January 2011 to September
2014.. Patients with polymicrobial VAP and patients with other previous or concurrent infections were excluded in the study.
https://www.ncbi.nlm.nih.gov/pubmed/30419545
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Improved outcome after trauma care in university-level intensive care units.
N= 2067. All adult trauma admissions excluding isolated head trauma and burns registered from July 1999 to December 2006 were analyzed using Finnish databases. Data from 22 ICUs were available. The non-university-affiliated units were categorized according to the number of beds and referral population as small, mid size and large. Acute physiology and chronic health evaluation (APACHE II)- and sequential organ failure assessment (SOFA)-adjusted mortalities were compared between the units.
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Rate and patterns of ICU admission among colorectal cancer patients: a single-center experience.
N = 89. Patients with colorectal cancer at a single institution admitted to an ICU"Risk of mortality goes up 42% with 1 point increase in SOFA score"
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Cross-validation of a Sequential Organ Failure Assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit.
N = 6645. Retrospective observational study including adults admitted to the intensive care unit (ICU) between January 1, 2006, and December 31, 2008
"We found good discrimination of the SOFA score in predicting mortality in medical and surgical admissions."
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Frailty increases mortality among patients ≥ 80 years old treated in Polish ICUsPatients of 80 years of age or older admitted to Polish ICUs were considered eligible for the study.Between November 2016 and February 2017, 272 participants were enrolled in the study.(272 patients)
https://www.ncbi.nlm.nih.gov/pubmed/30242826
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Epidemiology and Changes in Mortality of Sepsis After the Implementation of Surviving Sepsis Campaign Guidelines.
N: 229(year 2011 ) 311(year 2002) study conducted during a 5-month period (February to June, 2011) in 11 medical/surgical ICUs of 10 teaching hospitals in the Spanish region of Castilla y Leo´n (Supplemental Table S1).
https://www.ncbi.nlm.nih.gov/pubmed/28651474
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Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis.
N=103, We conducted this single center analysis from May 2011 through April 2012 at Dong-A University Hospital, Busan, Korea. We screened 207 patients with a serum CO2 concentration ,20 mEq/L and a plasma lactic acid concentration.(lactic acidosis as a lactic acid level .30 mg/dL)
https://www.ncbi.nlm.nih.gov/pubmed/23755210
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Predictors of Mortality in Patients Successfully Weaned from Extracorporeal Membrane Oxygenation119 critically ill patients successfully weaned from extracorporeal membrane oxygenation at the specialized intensive care unit of a tertiary-care university hospitalSequential Organ Failure Assessment (SOFA) score displayed good discriminative power (AUROC 0.805±0.055, p<0.001). Furthermore, multiple logistic regression analysis indicated that daily urine output on the second day of ECMO removal (UO24–48 hour), mean arterial pressure (MAP), and SOFA score on the day of ECMO removal were independent predictors of hospital mortality. Finally, cumulative survival rates at 6-month follow-up differed significantly (p<0.001) for a SOFA score≤13 relative to those for a SOFA score>13.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0042687
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Role of serum creatinine and prognostic scoring systems in assessing hospital mortality in critically ill cirrhotic patients with upper gastrointestinal bleeding76 patients with liver cirrhosis and upper gastrointestinal bleeding were admitted to the ICUNotably, the mean SOFA and APACHE III on the ICU 1st day were significantly higher in nonsurvivors than in survivors, 12.0 ± 3.4 vs. 6.6 ± 2.7 (p<0.001), and 117.6 ± 34.6 vs. 63.1 ± 26.9 (p<0.001), respectively. The calibration of SOFA (Lemeshow-Hosmer Chisquare = 3.604, 7 degrees of freedom (df), p=0.824), APACHE III (Lemeshow-Hosmer Chi-square = 8.320, 7 df, p=0.305) and Child-Pugh (Lemeshow-Hosmer Chi-square = 8.842, 5 df, p=0.116) displayed good agreement between the observed and expected mortality across all risk groups, supported by the formal goodness-of-fit test.https://www.researchgate.net/publication/8940695_Role_of_serum_creatinine_and_prognostic_scoring_systems_in_assessing_hospital_mortality_in_critically_ill_cirrhotic_patients_with_upper_gastrointestinal_bleeding
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Prediction of Patient Outcome from Acinetobacter baumannii Bacteremia with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II Scores110 patients with A. baumannii bacteremia were included in this retrospective study during the 40-month study periodSOFA >8, APACHE II >29 and SOFA >7, APACHE II >23 are associated with significantly higher 14-day and in-hospital mortality rates, respectively.https://www.jstage.jst.go.jp/article/internalmedicine/50/8/50_8_871/_pdf/-char/en
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Multiple-center evaluation of mortality associated with acute kidney injury in critically ill patients: a competing risks analysis8639 patients admitted between 1997 and 2009 to 13 French medical or surgical intensive care unitshttps://ccforum.biomedcentral.com/articles/10.1186/cc10241
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Sepsis-related Organ Failure Assessment Score is a strong predictor of survival in acute-on-chronic liver failure53 adult patients with decompensated alcoholic liver cirrhosisThe ten-day, 30-day, 90-day, and one-year mortality were 36%, 57%, 66%, and 80%, respectively. Univariate Cox regression analysis showed that only a high SOFA score and old age were independently associated with increased mortality. These two variables were combined to the Age-SOFA index to predict the probability of surviving a given period.https://www.ncbi.nlm.nih.gov/pubmed/31315795
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Negative Fluid Balance predicts Survival in Patients with septic shockn=37 admitted with a diagnosis of septic shock. Ranged of 16-85 years old, with a mean of 67. Mean day 1 SOFA score was 9.0
Patients with SOFA >10 had a RR of survival of 5.0, compared to those <10 whose RR was 3.3 for a combined RR of 3.5
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/10858412
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Mital annular plane systolic excursion (MAPSE) in shock: a valuable echocardiopgraphic parameter in intensive care patientsn=50 (>18 years) with systemic inflammatory response syndrome (SIRS) and concurrent shock, as defined by mean arterial pressure >70mmhg. Median age of 65, 28% female, SOFA score of 12
Odds ratio for predictor of 28-day mortality in patients with shock was 1.596 for SOFA score
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/23718803?log$=activity
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Model for end-stage liver disease score predicts mortality in critically ill cirrhotic patientsn= 508 of medical or surgical admissions with liver cirrhosis, mean age of 57, majority male.
28-survival Odds Ratio per point of SOFA - 1.17 for medical patients and 1.06 for surgical patients
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/24974049?log$=activity
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Prevalence of acute kidney injury and prognostic significance in patients with acute myocarditis n=101 patients suffering from acute myocarditis but free from chronic renal insufficiency. Mean age of 39 years (+/- 14.8), 54% male. Median SOFA score of 8 (4.5-11)
OR of SOFA as a predictive factor for in-hospital mortality: 1.0 (1.1-1.5) univariate, 1.3 (0.7-2.5) multivariate
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/23144725?log$=activity
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Systemic inflammatory response syndrome in sepsis-3: a retrospective studyn= 631. 538 (85.3%) SIRS-positive sepsis or septic shock, 93 (14.7%) SIRS-negative sepsis or septic shock. Median age of 60 66.1% male, median SOFA score of 9 (7-12) at baseline
OR of SOFA as a risk factor for mortality 1.18 (1.12-1.25), AUC = 0.70. SIRS is weaker than SOFa in predictive efficacy for in-hospital death
https://www-ncbi-nlm-nih-gov.proxy1.library.jhu.edu/pubmed/30744579?log$=activity
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Organ dysfunction and long term outcome in secondary peritonitis.
163 consecutive patients with secondary peritonitis were included, except those with post-
operative or traumatic peritonitis.( adults patients operated between January 2001 and December 2003 with an operative diagnosis of a perforated viscus and peritoneal infection in the Meilahti hospital of the Helsinki University Central Hospital )
https://www.ncbi.nlm.nih.gov/pubmed/17372753
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Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia142 bacterimia patients. All the patients were >18 years of age and tested positive for S. maltophilia in 1
or more blood cultures between December 2005 and 2014.
https://pubmed.ncbi.nlm.nih.gov/27495046/
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Dynamic Change of Red Cell Distribution Width Levels in Prediction of Hospital Mortality in Chinese Elderly Patients With Septic ShockN=45, Between September 2013 and September 2015, the elderly septic shock patients with RDW level beyond 15% were enrolled in this study From September 2013 to September 2015, in ICU of Shanghai Jiading District Central Hospital..
https://pubmed.ncbi.nlm.nih.gov/28485319/
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Scoring systems in acute pancreatitis: which one to use in intensive care units?
single institution review of 55 consecutive AP (acute pancreatitis) patients admitted in ICU during a 2-year period.
https://pubmed.ncbi.nlm.nih.gov/20149591/
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Mortality and risk factor analysis for Candida blood stream infection: A multicenter study.
N= 289, cases of candidemia between April 2011 and March 2016 in five regional hospitals in Japan.
https://pubmed.ncbi.nlm.nih.gov/30718191/
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Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review
Of 200 studies initially identified, 18 met the inclusion criteria and were included in this study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646326/