Predictive performance of SOFA (Sequential Organ Failure Assessment) and qSOFA (quick Sequential Organ Failure Assessment) for in-hospital mortality in ICU patients with COVID-19 of referral center in the north of Iran a retrospective study

Abstract

Introduction: Patients diagnosed with Coronavirus disease 2019 exhibit varied clinical outcomes, with a reported mortality rate exceeding 30% in those requiring admission to the ICU. The objective of this study was to assess the predictive capacity of Sequential Organ Failure Assessment (SOFA) and quick Sequential Organ Failure Assessment (qSOFA) scores in determining mortality risk among severe COVID-19 patients. Method and materials: This retrospective study was performed by analyzing the data of patients with COVID-19 who were hospitalized in the ICUs. Data collection of the parameters required to calculate the SOFA and qSOFA Scores were extracted from patient’s medical records. All data analysis was performed using SPSS V.25. Significance level considered as P less than 0.05. Findings: In this study, 258 patients were included. The results showed that the subjects ranged in age from 21 to 98 years with a mean and SD of 62.7±15.6. Of all patients, 127 (49.2%) were female and the rest were male. The mortality rate was 102 (39.5%). The underlying disease of diabetes mellitus with an odds ratio of 1.81 (CI=1.02–3.22) had a significant effect on mortality. In addition, a significant correlation was obtained between admission duration and SOFA score (r=0.147, P=0.018). The SOFA had a very high accuracy of 0.941 and at the cut-off point less than 5 had a sensitivity and specificity of 91.2% and 82.7%. In addition, qSOFA had high accuracy (0.914) and a sensitivity and specificity of 87.3% and 91.7% at the optimal cutting point of greater than 1. Conclusion: The findings of present study illustrated that deceased COVID-19 patients admitted to the ICU had higher scores on both SOFA and qSOFA scales than surviving patients. Also, both scales have high sensitivity and specificity for anticipating of mortality in these patients. The underlying diabetes mellitus was associated with an increase in patient mortality.