Sequential Organ Failure Assessment Score (Sofa Score) for Evaluating Outcome of Severe Maternal Morbidity in Obstetric Intensive Care

Introduction: Severe Maternal Morbidity (SMM) is a progressive process and life - threatening condition for a pregnant woman and if not managed in - time eventually may lead to maternal death. Therefore, an early identification of patients at risk of increasing organ damage could have an impact in terms of outcome improvement. Objectives: To determine the prognostic accuracy of Sequential Organ Failure Assessment Score (SOFA) for evaluating organ failure and outcome of severe maternal morbidity in obstetrics intensive care. To correlate the SOFA, qSOFA (quick SOFA) Score and duration of ICU Stay with maternal mortality. Methods: A prospective observational cohort study was conducted on 164 women admitted in ten bedded multidisciplinary ICU. Patients were followed up daily and total and maximum SOFA scores were calculated. qSOFA score was calculated at the time of admission. ROC curve was made to determine optimum cut off and the prognostic accuracy of SOFA and qSOFA score. Mean SOFA, qSOFA score and duration of ICU stay were compared between survivors and non survivors. Results: Mean age of the study population was 25.78 ? 3.97 years. Eclampsia (36.58%) followed by haemorrhage (20.73%) were the most common causes of ICU admission. Mortality rate was 28.7%. Total maximum SOFA scores were significantly higher in non - survivors than in survivors (14.1 ? 2.7 vs 6.9 ? 1.9). At cut off of 10, AUC was 0.988 (95%CI, SE 0.006, 0.977 - 1.000; p<0.001) which demonstrated that the SOFA score was a reliable predictor of mortality. Also, qSOFA scores were higher in non - survivors than in survivors (2.8 ? 0.4 vs 1.6 ? 0.6). A significant association of increasing duration of ICU stay and mortality was found. Conclusion: Sequential Organ Failure Score showed good predictive and diagnostic abilities for maternal mortality in patients with SMM admitted to ICU.