Comparison of Simplified Acute Physiology Score III and Sequential Organ Failure Assessment on Detection Prognosis of Mortality in Patients with Trauma Admitted to the Intensive Care Units of Alzahra Hospital, Isfahan, Iran, in 2015

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center AND Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Recently, there are many scoring systems to determine the mortality rate among the patients with trauma. The aim of this study was to compare the Simplified Acute Physiology Score (SAPS) III and Sequential Organ Failure Assessment (SOFA) tests in determining the degree of mortality in patients with trauma admitted to the intensive care units (ICU).Methods: In this retrospective cross-sectional study, mortality rate was assessed using of SOFA and SAPS III scorings on 100 patients with trauma who admitted to the intensive care units of Alzahra Hospital, Isfahan, Iran, in 2015, according to the inclusion and exclusion criteria. The patients were also divided into two groups of survive and non-survive based on mortality.Findings: The mean SOFA scores in survive and non-survive groups were 6.20  ±2.97 and 14.16 ± 2.69, and mean SAPS III scores were 35.02  ±12.67 and 60.96±  13.54, respectively. The SOFA and SAPS III scores in the non-survive group were significantly higher than survive group (P < 0.001 for both tests). Sensitivity and specificity rates of the SOFA test were 69.26% and 29.92%, and for SAPS III test, 68.22% and 32.25%, respectively.Conclusion: Both SOFA and SAPS III scorings are good criteria for predicting mortality in patients with trauma admitted to the intensive care units. So, the sensitivity and specificity of the two tests were roughly similar, but the convenience and simplicity of the SOFA test were more in determining of mortality rate.

Keywords


  1. Hwang SY, Lee JH, Lee YH, Hong CK, Sung AJ, Choi YC. Comparison of the Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II scoring system, and Trauma and Injury Severity Score method for predicting the outcomes of intensive care unit trauma patients. Am J Emerg Med 2012; 30(5): 749-53.
  2. Bouillon B, Neugebauer E, Rixen D, Lefering R, Tiling T. Value of clinical scoring systems for evaluation of injury severity and as an instrument for quality management of severely injured patients. Zentralbl Chir 1996; 121(11): 914-23. [In German].
  3. Fueglistaler P, Amsler F, Schuepp M, Fueglistaler-Montali I, Attenberger C, Pargger H, et al. Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II Score compared with trauma scores in the outcome of multiple-trauma patients. Am J Surg 2010; 200(2): 204-14.
  4. Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med 1998; 26(11): 1793-800.
  5. Reiter A, Mauritz W, Jordan B, Lang T, Polzl A, Pelinka L, et al. Improving risk adjustment in critically ill trauma patients: The TRISS-SAPS Score. J Trauma 2004; 57(2): 375-80.
  6. Moreno RP, Metnitz PG, Almeida E, Jordan B, Bauer P, Campos RA, et al. SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med 2005; 31(10): 1345-55.
  7. Nair R, Bhandary NM, D'Souza AD. Initial Sequential Organ Failure Assessment score versus Simplified Acute Physiology score to analyze multiple organ dysfunction in infectious diseases in Intensive Care Unit. Indian J Crit Care Med 2016; 20(4): 210-5.
  8. Hosseini M, Ramazani J. Evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems for prognostication of outcomes among Intensive Care Unit's patients. Saudi J Anaesth 2016; 10(2): 168-73.
  9. Cardenas-Turanzas M, Ensor J, Wakefield C, Zhang K, Wallace SK, Price KJ, et al. Cross-validation of a Sequential Organ Failure Assessment score-based model to predict mortality in patients with cancer admitted to the intensive care unit. J Crit Care 2012; 27(6): 673-80.
  10. Geerse DA, Span LF, Pinto-Sietsma SJ, van Mook WN. Prognosis of patients with haematological malignancies admitted to the intensive care unit: Sequential Organ Failure Assessment (SOFA) trend is a powerful predictor of mortality. Eur J Intern Med 2011; 22(1): 57-61.
  11. Li Y, Li C. Comparison of simplified acute physiology score III and other scoring systems in prediction of 28-day prognosis in patients with severe sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2015; 27(6): 454-9. [In Chinese].