A study of predictors of outcome in paediatric intensive care unit with special reference to SOFA score
Keywords:SOFA score, MODS, Immunization, Sepsis
Background: Multi-organ dysfunction syndrome (MODS) is the leading cause of morbidity and mortality for patients admitted in Pediatric Intensive care unit. The Sequential organ failure assessment (SOFA) score is an objective score that allows for calculation of both the number and the severity of organ dysfunction in six organ systems. It is a six-organ dysfunction score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal). This scoring system guides the efficient utilization of hospital resources, especially in a resource starved setting and useful to evaluate the prognostication, to counsel the guardians and to decide therapeutic interventions. The score can also be a useful in clinical research tool to evaluate various therapeutic interventions in MODS. The aim of the study was to predict outcome in pediatric intensive care unit with special reference to SOFA score in patients admitted to civil hospital, Ahmedabad.
Methods: We have randomly selected 120 patients who were admitted in pediatric intensive care unit of tertiary care hospital and full-filing inclusion and exclusion criteria included in our study.
Results: There are multiple factors responsible for predicting the outcome in critically ill patients admitted in pediatric intensive care unit. Patients with complete immunization status have better outcome as compared to patients with incomplete immunization and unimmunized status. Patients with higher socioeconomic class have slightly better outcome as compared to patients with lower socioeconomic class.
Conclusions: SOFA score is a good objective score as a predictor of mortality in critically ill patients. But, if SOFA is calculated at the time of admission, then it has poor diagnostic accuracy in prediction of outcome. So, SOFA score at 72 hours of admission (T72) and delta SOFA (T72-T0) are better predictors of poor outcome as compared to SOFA score at admission (T0).
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