Aims: The purpose of this study was to evaluate the usefulness of repeated measurements
of the SOFA score in terms of survival in cardiac surgery patients.
Methods: This prospective study consisted of all consecutive adult patients undergoing cardiac
surgery with cardiopulmonary bypass between January 2003 and October 2005. The SOFA
score was calculated daily until discharge. Initial SOFA score, maximum SOFA score,
and delta-SOFA scores (differences between subsequent scores) were calculated and
their correlations with mortality were assessed.
Results: A total of 2372 patients with a mean age of 66.2±11.2 years were admitted to the
ICU after cardiac surgery. The operations performed were 1518 (64%) isolated CABG,
332 (14%) isolated valve surgery, 237 (10%) combined CABG with valve surgery, 95 (4%)
surgery of the thoracic aorta, and 190 (8%) other procedures. The overall mortality
rate was n=85 (3.6%). The mean stay on the ICU was 3.0±6.1 days. The receiver operating
characteristic (ROC) curve of the maximum SOFA score was excellent with a value of
0.97. When analyzing trends in the SOFA Score during the first 96 hours (1038 patients),
regardless of the initial score, the mortality rate was 30.6% when the score increased,
17.2% when it remained unchanged, and 2.0% when it decreased.
Conclusion: The highest SOFA Score during the ICU stay showed an excellent discrimination. Serial
evaluation of the SOFA Score during the first 96 hours is a good indicator of prognosis
in cardiac surgical patients.
