Maximum sequential organ failure assessment score and average sequential organ failure assessment score for prediction of clinical outcomes in patients with sepsis caused by common Gram-positive/negative bacteria

Abstract

Objective To evaluate the application value of maximum sequential organ failure assessment (SOFA) score and mean SOFA score for the prediction of clinical outcome in patients with sepsis caused by gram-positive/gram-major pathogens. Methods Patients diagnosed sepsis of emergency ICU and comprehensive ICU of our hospital, from Oct. 2016 to Jul. 2017 were included in our study. Blood culture and sputum culture were immediately taken at the time of admission, and the pathogenic bacteria were isolated. All patients were divided into Gram-negative bacteria (G-) group and Gram-positive bacteria (G+) group and G-pathogenic bacteria (G+) group according to the pathogen test results. PO2/FiO2 (represented respiratory system function), total bilirubin (represented liver function), creatinine (represented kidney function), mean arterial pressure (represented circulation system function), platelet count (represented coagulation function), and GCS score (represented brain function) were collected at the time of admission, 24 hours, 48 hours, 72 hours, 4 days, 5 days... after admission, until the patient died or out of hospital. Then, calculated maximum SOFA score and mean SOFA score. Results Totally 62 patients were enrolled, including 20 females and 42 males, with an average age of (65.79±14.17) years. There were 28 cases in the G+ group and 34 cases in the G- group. The maximum SOFA score showed a clear correlation with the number of patient′s organ failure (G+ male, correlation coefficient 0.927; G+ female, correlation coefficient 0.847, P<0.05; G- male, correlation coefficient 0.719, P<0.01); the maximum SOFA score was significantly associated with the prognosis of death of patients (G+ correlation coefficient 0.480, G- correlation coefficient 0.621, P<0.01); the maximum SOFA score showed the highest area under the ROC curve. Conclusions Maximum SOFA score was associated with the number of patient′s organ failure and the death outcome of patient. Maximum SOFA score also showed more significance value in evaluating prognosis. Key words: SOFA core; Gram-positive pathogen; Gram-negative pathogen; Clinical outcome