Prognostic validity and reliability of the sofa score in multiple trauma patients

Background: This study evaluated the reliability of the SOFA score in prediction of outcome in multiple traumatized patients. Methods: 44 multiple traumatized patients admitted to surgical ICU were prospectively enrolled. The SOFA score was evaluated daily throughout the first seven days of ICU stay and at ICU discharge, whereas the total maximum SOFA score was recorded as the worst of all daily recorded scores. Glasgow Outcome Scale (GOS) was used to assess outcome at time of ICU discharge. The quality of outcome was categorized as survival with either good outcome (good recovery and moderate disability) or poor outcome (severe disability and vegetative state), and non-survival. All recorded scores were analyzed in relation with both GOS and quality of outcome. Results: No significant correlation was found between SOFA score at the first and second days of ICU stay with either GOS or the quality of outcome. The correlation between SOFA score with GOS and quality of outcome exhibited the earliest significance at the third day (P <0.05), and then showed a trend of progressive improvement with subsequent daily scores till became maximum at the seventh day, at ICU discharge, and for the total maximum SOFA score. At the third day of ICU stay, survival was associated with median SOFA score of 5 for good outcome, and 7 for poor outcome, whereas, non-survival was associated with median SOFA score of 9. Conclusion: The SOFA score provides valid and reliable prognostic information in multiple trauma patients. While the best prognostic capability was achieved for the SOFA score at the seventh day of ICU stay, at ICU discharge, and for the total maximum SOFA score, SOFA score at the third day exhibited the earliest reliable outcome prediction with efficient discrimination among survivors with good outcome or poor outcome versus non-survivors.