Adverse Sequential Organ Failure Assessment Score as a Predictor of Mortality in    Patients Requiring Critical Care in Pakistan

Objective: To determine the sensitivity, specificity, and diagnostic accuracy of the Sequential Organ Failure Assessment score in predicting one-month mortality in patients requiring critical care. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Rawalpindi, Pakistan Apr to Oct 2020. Methodology: This study was conducted on 173 patients requiring intensive care. All patients aged between 20 and 70 years diagnosed with disorders secondary to traumatic causes or otherwise who were admitted for critical care were included. Patients were assessed at the time of admission to the intensive care unit, and their Sequential Organ Failure Assessment scores were calculated. A cut-off level of ≥7 was considered to be a high risk for mortality within thirty days of admission. All patients were followed up for thirty days for the mortality. Results: Mean age of our patients was 43.04±11.26 years, of whom 109(60.6%) patients were male. A SOFA score of ≥7 in predicting the mortality within thirty days of admission for critical care carried a sensitivity of 31.40%, a specificity of 25.53%, a positive predictive value of 27.84%, a negative predictive value of 28.92% and a diagnostic accuracy of 28.33%. Conclusion: The Sequential Organ Failure Assessment score lacks the diagnostic accuracy to precisely predict the mortality in critically ill patients within thirty days of developing the requirement for critical care.