Application of the Sequential Organ Failure Assessment (SOFA) Score to Bacteremic ICU Patients |
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Authors: | C Routsi M Pratikaki C Sotiropoulou E Platsouka V Markaki O Paniara J-L Vincent C Roussoss |
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Institution: | (1) Dept. of Intensive Care, Evangelismos Hospital, University of Athens, Athens, Greece;(2) Dept. of Clinical Microbiology, Evangelismos Hospital, Athens, Greece;(3) Dept. of Intensive Care, Erasme Hospital, Free University of Brussels, Brussels, Belgium;(4) ICU Dept, Evangelismos Hospital, 45-47 Ipsilantou Str., Athens, 106 76, Greece |
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Abstract: | Abstract
Background: Patients admitted to intensive care units (ICUs) are at a high risk of acquiring blood stream infections. We examined whether
SOFA score on ICU admission and on the day of bacteremia can predict the occurrence of bacteremia and the outcome of bacteremic
ICU patients.
Patients and Methods: All patients admitted to a multidisciplinary ICU for more than 48 h from January 1, 2002 to December 31, 2004, were prospectively
studied. Demographic, clinical and laboratory data were recorded on admission for all patients and additionally, on the day
of the first bacteremic episode for those patients who developed bacteremia. Accordingly, APACHE II and SOFA scores were calculated
on the same day.
Results: A total of 185 patients developed one or more episodes of bacteremia, giving an incidence of 9.6 per 1,000 ICU days. The ICU
mortality rate was 43.9% for bacteremic and 25.8% for the remaining patients (p < 0.001). Admission SOFA score was independently
associated with the occurrence of bacteremia (OR = 1.20, 95% CI: 1.11–1.26, p < 0.001). Among bacteremic patients, SOFA score
on the day of bacteremia was the only independent prognostic factor for outcome (OR = 1.44, 95% CI: 1.21–1.71, p < 0.001).
When all patients were included in the multivariate analysis, admission SOFA (OR = 1.3, CI: 1.16–1.38, p < 0.001), APACHE
II (OR = 1.1, CI: 1.02–1.11, p = 0.003) score and the presence of bacteremia (OR = 1.8, CI: 1.1–2.9, p = 0.023) were independently
associated with the outcome.
Conclusion: Admission SOFA score is independently associated with the occurrence of ICU-acquired bacteremia, whereas it is not sufficient
to predict the outcome of patients who subsequently will develop this complication. However, SOFA score on the first day of
bacteremia is an independent prognostic factor for outcome in these patients. |
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