Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models
Abstract Background There are many prognostic models and scoring systems in use to predict mortality in ICU patients. The only general ICU scoring system developed and validated for patients after cardiac surgery is the APACHE-IV model. This is, however, a labor-intensive scoring system requiring a...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-03-01
|
Series: | BMC Anesthesiology |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12871-020-00975-2 |
id |
doaj-4ed64c209536400ea089606cf289098b |
---|---|
record_format |
Article |
spelling |
doaj-4ed64c209536400ea089606cf289098b2020-11-25T03:59:36ZengBMCBMC Anesthesiology1471-22532020-03-012011810.1186/s12871-020-00975-2Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–modelsAbraham Schoe0Ferishta Bakhshi-Raiez1Nicolette de Keizer2Jaap T. van Dissel3Evert de Jonge4Department of Intensive Care, Leiden University Medical Center, University of LeidenDepartment of Medical Informatics, Amsterdam Public Health research institute, Amsterdam Medical Center, University of AmsterdamDepartment of Medical Informatics, Amsterdam Public Health research institute, Amsterdam Medical Center, University of AmsterdamDepartment of infectious diseases, Leiden University Medical Centre, University of LeidenDepartment of Intensive Care, Leiden University Medical Center, University of LeidenAbstract Background There are many prognostic models and scoring systems in use to predict mortality in ICU patients. The only general ICU scoring system developed and validated for patients after cardiac surgery is the APACHE-IV model. This is, however, a labor-intensive scoring system requiring a lot of data and could therefore be prone to error. The SOFA score on the other hand is a simpler system, has been widely used in ICUs and could be a good alternative. The goal of the study was to compare the SOFA score with the APACHE-IV and other ICU prediction models. Methods We investigated, in a large cohort of cardiac surgery patients admitted to Dutch ICUs, how well the SOFA score from the first 24 h after admission, predict hospital and ICU mortality in comparison with other recalibrated general ICU scoring systems. Measures of discrimination, accuracy, and calibration (area under the receiver operating characteristic curve (AUC), Brier score, R2, and Ĉ-statistic) were calculated using bootstrapping. The cohort consisted of 36,632 Patients from the Dutch National Intensive Care Evaluation (NICE) registry having had a cardiac surgery procedure for which ICU admission was necessary between January 1st, 2006 and June 31st, 2018. Results Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict hospital mortality was good with an AUC of respectively: 0.809, 0.851, 0.830, 0.850, 0.801. Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict ICU mortality was slightly better with AUCs of respectively: 0.809, 0.906, 0.892, 0.919, 0.862. Calibration of the models was generally poor. Conclusion Although the SOFA score had a good discriminatory power for hospital- and ICU mortality the discriminatory power of the APACHE-IV and SAPS-II was better. The SOFA score should not be preferred as mortality prediction model above traditional prognostic ICU-models.http://link.springer.com/article/10.1186/s12871-020-00975-2ICU-scoring systemsICU mortalitySOFA scoreMortality discriminationCardiac surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abraham Schoe Ferishta Bakhshi-Raiez Nicolette de Keizer Jaap T. van Dissel Evert de Jonge |
spellingShingle |
Abraham Schoe Ferishta Bakhshi-Raiez Nicolette de Keizer Jaap T. van Dissel Evert de Jonge Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models BMC Anesthesiology ICU-scoring systems ICU mortality SOFA score Mortality discrimination Cardiac surgery |
author_facet |
Abraham Schoe Ferishta Bakhshi-Raiez Nicolette de Keizer Jaap T. van Dissel Evert de Jonge |
author_sort |
Abraham Schoe |
title |
Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models |
title_short |
Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models |
title_full |
Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models |
title_fullStr |
Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models |
title_full_unstemmed |
Mortality prediction by SOFA score in ICU-patients after cardiac surgery; comparison with traditional prognostic–models |
title_sort |
mortality prediction by sofa score in icu-patients after cardiac surgery; comparison with traditional prognostic–models |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2020-03-01 |
description |
Abstract Background There are many prognostic models and scoring systems in use to predict mortality in ICU patients. The only general ICU scoring system developed and validated for patients after cardiac surgery is the APACHE-IV model. This is, however, a labor-intensive scoring system requiring a lot of data and could therefore be prone to error. The SOFA score on the other hand is a simpler system, has been widely used in ICUs and could be a good alternative. The goal of the study was to compare the SOFA score with the APACHE-IV and other ICU prediction models. Methods We investigated, in a large cohort of cardiac surgery patients admitted to Dutch ICUs, how well the SOFA score from the first 24 h after admission, predict hospital and ICU mortality in comparison with other recalibrated general ICU scoring systems. Measures of discrimination, accuracy, and calibration (area under the receiver operating characteristic curve (AUC), Brier score, R2, and Ĉ-statistic) were calculated using bootstrapping. The cohort consisted of 36,632 Patients from the Dutch National Intensive Care Evaluation (NICE) registry having had a cardiac surgery procedure for which ICU admission was necessary between January 1st, 2006 and June 31st, 2018. Results Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict hospital mortality was good with an AUC of respectively: 0.809, 0.851, 0.830, 0.850, 0.801. Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict ICU mortality was slightly better with AUCs of respectively: 0.809, 0.906, 0.892, 0.919, 0.862. Calibration of the models was generally poor. Conclusion Although the SOFA score had a good discriminatory power for hospital- and ICU mortality the discriminatory power of the APACHE-IV and SAPS-II was better. The SOFA score should not be preferred as mortality prediction model above traditional prognostic ICU-models. |
topic |
ICU-scoring systems ICU mortality SOFA score Mortality discrimination Cardiac surgery |
url |
http://link.springer.com/article/10.1186/s12871-020-00975-2 |
work_keys_str_mv |
AT abrahamschoe mortalitypredictionbysofascoreinicupatientsaftercardiacsurgerycomparisonwithtraditionalprognosticmodels AT ferishtabakhshiraiez mortalitypredictionbysofascoreinicupatientsaftercardiacsurgerycomparisonwithtraditionalprognosticmodels AT nicolettedekeizer mortalitypredictionbysofascoreinicupatientsaftercardiacsurgerycomparisonwithtraditionalprognosticmodels AT jaaptvandissel mortalitypredictionbysofascoreinicupatientsaftercardiacsurgerycomparisonwithtraditionalprognosticmodels AT evertdejonge mortalitypredictionbysofascoreinicupatientsaftercardiacsurgerycomparisonwithtraditionalprognosticmodels |
_version_ |
1724453916113895424 |