Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed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

Ashuin Kammar-García
* ORCID logo ,
Lilia Castillo-Martínez
,
Javier Mancilla-Galindo
ORCID logo ,
José Luis Villanueva-Juárez
,
Anayeli Pérez-Pérez
,
Héctor Isaac Rocha-González
ORCID logo ,
Jesús Arrieta
ORCID logo ,
Miguel Remolina-Schlig
,
Thierry Hernández-Gilsoul
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.

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 and Pharmacology, Emergency Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.