ORIGINAL ARTICLE

Sequential (Sepsis-Related) Organ Failure Assessment (SOFA) as a predictor of mortality and its correlation with capillary lactate levels in sepsis patients

Made Susila Utama , Candra Lasmono, Tuti Parwati Merati

Made Susila Utama
Internal Medicine Department, Sanglah Hospital, Udayana University. Email: susila_dalung@yahoo.co.id

Candra Lasmono
Internal Medicine Department, Sanglah Hospital, Udayana University

Tuti Parwati Merati
Internal Medicine Department, Sanglah Hospital, Udayana University
Online First: August 01, 2018 | Cite this Article
Utama, M., Lasmono, C., Merati, T. 2018. Sequential (Sepsis-Related) Organ Failure Assessment (SOFA) as a predictor of mortality and its correlation with capillary lactate levels in sepsis patients. Bali Medical Journal 7(2). DOI:10.15562/bmj.v7i2.1109


Background. Sepsis is a life-threatening organ dysfunction, caused by the dysregulation of the body's response to infection. Sepsis remains one of the major causes of hospitalization and mortality in hospitals with large medical expenses. Sequential (sepsis-related) organ failure assessment/SOFA is a score that describes the presence of organ dysfunctions. Lactate is a metabolite formed  anaerobic respiration due to hypoperfusion. This study was conducted to determine the role of SOFA score as a predictor of sepsis mortality and its association with capillary lactate levels.

Method. This was an observational study with a cohort design. A sample of 68 subjects with sepsis was taken using consecutive sampling. Calculation of the SOFA score was performed at the beginning of sepsis diagnosis whilst capillary lactate examination was performed in the first 3 hours after diagnosis.

 Result. The most frequent cases of organ dysfunction based on SOFA score was respiration system (83.8%), kidney (58.8%), central nervous system (55.9%), cardiovascular (41.2%), coagulation (36.8%), hepatobiliary (23.5%). The mean score of SOFA and the initial capillary lactate level of the living group compared with the deceased group was 4.89±2.06 vs. 7.64±2.67 (p <0.05); 3.28±1.39 vs 3.60±1.43 (p 0.116). The best cut-off values of the SOFA score for mortality were ≥ 5.5 (area under curve/AUC 0.788, sensitivity 74.2% and specificity 62.2%, positive predictive value/PPV 62.2%, and negative predictive value/NPV 74.2%). The log-rank test of the Kaplan-Meier curve was statistically significant (p <0.05). Multivariate Cox regression analysis showed that the SOFA score with cut-off ≥5.5 could be used as a predictor of mortality in sepsis patients with a hazard ratio of 2.475 (p <0.05). Spearman correlation test between SOFA score with initial capillary lactate level was statistically significant (p <0.05) with correlation coefficient 0.319 (weak correlation)

Conclusion. The SOFA score with cut-off ≥5.5 can be used as a predictor of mortality in sepsis. The SOFA score correlated weakly with capillary lactate levels.

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