Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

SOFA Score Plus Impedance Ratio Predict Mortality in Critically Ill Patients Admitted to the Emergency Department: Retrospective Observational Study

Version 1 : Received: 24 March 2022 / Approved: 28 March 2022 / Online: 28 March 2022 (14:01:05 CEST)

A peer-reviewed article of this Preprint also exists.

Kammar-García, A.; Castillo-Martínez, L.; Mancilla-Galindo, J.; Villanueva-Juárez, J.L.; Pérez-Pérez, A.; Rocha-González, H.I.; Arrieta-Valencia, J.; Remolina-Schlig, M.; Hernández-Gilsoul, T. SOFA Score Plus Impedance Ratio Predicts Mortality in Critically Ill Patients Admitted to the Emergency Department: Retrospective Observational Study. Healthcare 2022, 10, 810. Kammar-García, A.; Castillo-Martínez, L.; Mancilla-Galindo, J.; Villanueva-Juárez, J.L.; Pérez-Pérez, A.; Rocha-González, H.I.; Arrieta-Valencia, J.; Remolina-Schlig, M.; Hernández-Gilsoul, T. SOFA Score Plus Impedance Ratio Predicts Mortality in Critically Ill Patients Admitted to the Emergency Department: Retrospective Observational Study. Healthcare 2022, 10, 810.

Journal reference: Healthcare 2022, 10, 810
DOI: 10.3390/healthcare10050810

Abstract

Background: The Sequential Organ Failure Assessment (SOFA) is a scoring system used for the evaluation of disease severity and prognosis of critically ill patients. The impedance ratio (Imp-R) is a novel mortality predictor. Aims: This study aimed to evaluate the combination of SOFA + Imp-R in the prediction of mortality in critically ill patients admitted to the emergency department (ED). Methods: A retrospective cohort study was performed in adult patients with acute illness admitted to the ED of a tertiary-care referral center. Baseline SOFA score and bioelectrical impedance analysis to obtain the Imp-R were performed within the first 24 hours after admission to the ED. A Cox regression analysis was performed to evaluate mortality risk of initial SOFA score plus Imp-R. Harrell's C-statistic and decision curve analyses (DCA) were performed. Results: Out of 325 patients, 240 were included for analysis. Overall mortality was 31.3%. Only 21.3% of non-surviving patients died after hospital discharge, and 78.4% died during hospital stay. Of the latter, 40.6% died in the ED. SOFA and Imp-R values were higher in non-survivors and were significantly associated with mortality in all models. The combination of SOFA + Imp-R significantly predicted 30-day mortality, in-hospital mortality, and ED mortality with area under the curve (AUC) of 0.80 (95% CI: 74-0.86), 0.79 (95% CI: 0.74-0.86) and 0.75 (95% CI: 0.66-0.84) respectively. The DCA showed that combining SOFA + Imp-R improved the prediction of mortality through the lower risk thresholds. Conclusion: The addition of Imp-R to baseline SOFA score at admission to the ED improves mortality prediction in severely acutely ill patients admitted to the ED.

Keywords

SOFA; Impedance ratio; mortality; emergency department; Critical care; prediction

Subject

MEDICINE & PHARMACOLOGY, General Medical Research

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