Reliability Of Sofa (Sequential Organ Failure Assessment) Score For Predicting Morbidity And Mortality In Acute Pancreatitis In A Tertiary Care Center
DOI:
https://doi.org/10.37506/ehmj1078Abstract
INTRODUCTION
Severe pancreatitis can cause high mortality, and scorings are essential in assessing and managing it. We used serial Sequential Organ Failure Assessment (SOFA)scores in assessing patients with acute severe pancreatitis to predict severity, intensive care unit admission, and mortality.
MATERIALS AND METHODS
Our study was a prospective, single-institutional review of 150 consecutive acute severe pancreatitis patients admitted to Coimbatore Medical College and Hospital from May 2019 to April 2020. Serial SOFA scores were calculated on admission, on days 2, 7, 14, and 21 of these patients.
RESULTS
The serial SOFA scores correlated significantly with mortality. Highest SOFA score of 11 and mean SOFA score of more than 8 correlated to mortality of more than 80%. Analyzing the trends in the SOFA score, the mortality rate was around 50% when the score increased, 30% when it remained unchanged, and less than 25 % when it showed a decreasing trend. Mortalitydifferences were better predicted by the first 48 hours SOFA score than in the subsequent 48 hours value. Prolonged hospital stay was associated with late mortality when compared with groups. When comparing other variables, the majority of pancreatitis was caused by alcohol consumption with high mortality observed in patients requiring organ support systems.
CONCLUSION
Changes in SOFA scores over time predicted the progression of organ failure, and escalating changes in SOFA score on hospital day 1 were subsequently associated with higher mortality rates. In our study, serial assessment of SOFA scores was found to be a cost-effective and easy method for predicting morbidity and mortality in acute pancreatitis patients.
References
Thomson SR, Hendry WS, McFarlane GA, Davidson AI. Epidemiology and outcome of acute pancreatitis. Br J Surg. 1987 May;74(5):398-401. doi: 10.1002/bjs.1800740526. PMID: 3594136.
Mutinga M, Rosenbluth A, Tenner SM, Odze RR, Sica GT, Banks PA. Does mortality occur early or late in acute pancreatitis? Int J Pancreatol. 2000 Oct;28(2):91-5. doi: 10.1385/IJGC:28:2:091. PMID: 11128978.
Uhl W, Isenmann R, Curti G, et al. Influence of etiology on the courseand outcome of acute pancreatitis. Pancreas 1996;13:335-43.
Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Kao L, et al. Schwartz’s principles of surgery 2-volume set 11th edition. 11th ed. Tata McGraw-Hill Education; 2019.
Williams M, Simms HH. Prognostic usefulness of scoring systems in critically ill patients with severe acute pancreatitis. Crit Care Med. 1999 May;27(5):901-7. doi: 10.1097/00003246-199905000-00023. PMID: 10362411.
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996 Jul;22(7):707-10. doi: 10.1007/BF01709751. PMID: 8844239.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818-29. PMID: 3928249.
Barrett KE, Barman SM, Brooks HL, Yuan J. Ganong’s review of medical physiology. 26th ed. New York: Mcgraw-Hill Education; 2019.
Beger HG, Rau B, Mayer J, Pralle U. Natural course of acute pancreatitis. World J Surg. 1997 Feb;21(2):130-5. doi: 10.1007/s002689900204. PMID: 8995067.
Tee YS, Fang HY, Kuo IM, Lin YS, Huang SF, Yu MC. Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine (Baltimore). 2018 Feb;97(7):e9654. doi: 10.1097/MD.0000000000009654. PMID: 29443733; PMCID: PMC5839831.
Srinivasan G, Venkatakrishnan L, Sambandam S, Singh G, Kaur M, Janarthan K, John BJ. Current concepts in the management of acute pancreatitis. J Family Med Prim Care. 2016 Oct-Dec;5(4):752-758. doi: 10.4103/2249-4863.201144. PMID: 28348985; PMCID: PMC5353808.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.