Validity of the SOFA Score in Predicting Mortality in the Field of Cardiovascular Surgery

Kanako Takai＊

Takaya Nakagawa＊＊

Takashi Yamauchi＊＊

（Department of Critical Care Medicine＊, and Department of Cardiovascular Surgery＊＊, Higashiosaka City Medical Center, Osaka, Japan)

Objective: The Sequential Organ Failure Assessment （SOFA） score is a useful tool in defining the clinical conditions and describing the acute morbidity of patient populations with critical illness. This study was performed to assess the usefulness of the SOFA score in predicting the prognosis among cardiac or thoracic aortic postoperative patients. Methods: In total, 123 patients who entered the intensive care unit after a cardiac or thoracic aortic operation from August 2019 to December 2020 were retrospectively investigated. The SOFA score cut-off value from the admission day to postoperative day 3 calculated in the first 60 patients （derivation group） was validated in the latter 63 patients （validation group）. Additionally, the Japan SCORE cut-off value calculated in the derivation group was validated in the validation group. Results: The perioperative mortality rate, in-hospital mortality rate and hospital transfer rate were 4.9, 7.3, and 13.2%, respectively. A SOFA score cut-off value of ≥7 for prediction of in-hospital mortality resulted in a sensitivity of 100% and specificity of 81% on postoperative day 2, followed by high sensitivity of 100% and specificity of 95% on postoperative day 3. A SOFA score cut-off value of ≥6 for prediction of hospital transfer resulted in a sensitivity of 57% and a specificity of 67% on postoperative day 2. Conclusion: The SOFA score on postoperative day 2 provides good discriminatory power for in-hospital mortality among cardiac or thoracic aortic postoperative patients. The SOFA scoring system could be useful for predicting short-term prognosis of patients who undergo cardiac or thoracic aortic surgery.

 

Jpn. J. Cardiovasc. Surg. 51: 197-203 （2022）

Keywords：sequential organ failure assessment; postoperative prognosis; cardiac operative patients