Mortality indicators in sepsis patients in ICU: SOFA VS PIRO

Abstract

BACKGROUND: SOFA represents a simple and objective score that allows for calculation of both the number and severity of organ dysfunction. PIRO is a conceptual classification system in which a number of demographic, clinical, biological and laboratory variables are used to stratify patients with sepsis in 4 categories.

OBJECTIVES:   1.              To determine the accuracy of PIRO vs. SOFA scores in predicting mortality in sepsis patients in ICU.

1. To determine whether any other confounding factor influences mortality in ICU during our study.

STUDY DESIGN: Prospective observational study.

PARTICIPANTS:  200 sepsis patients admitted in ICU, 18 years or older, having 2 or more SIRS criteria.

METHODS: The PIRO and SOFA scores were calculated from the individual data elements collected in the ICU and recorded on the charts. The most abnormal value recorded in the ICU was used in the score calculations. All data were abstracted into structured proformas by a single investigator.

RESULTS: Among patients admitted to the ICU (n = 200), the PIRO score was superior to the SOFA score: AUC 0.58 versus 0.45.

CONCLUSION:  The PIRO model, taking into account comorbidities and septic source as well as physiologic status, performed better than the SOFA for predicting mortality in sepsis patients in ICU.

IMPLICATIONS:  These findings have implications for identifying and managing high-risk patients, and for the design of clinical trials in sepsis.