Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II score compared with trauma scores in the outcome of multiple-trauma patients

Abstract 

Background

Prospective data regarding the prognostic value of the Sequential Organ Failure Assessment (SOFA) score in comparison with the Simplified Acute Physiology Score (SAPS II) and trauma scores on the outcome of multiple-trauma patients are lacking.

Methods

Single-center evaluation (n = 237, Injury Severity Score [ISS] >16; mean ISS = 29). Uni- and multivariate analysis of SAPS II, SOFA, revised trauma, polytrauma, and trauma and ISS scores (TRISS) was performed.

Results

The 30-day mortality was 22.8% (n = 54). SOFA day 1 was significantly higher in nonsurvivors compared with survivors (P < .001) and correlated well with the length of intensive care unit stay (r = .50, P < .001). Logistic regression revealed SAPS II to have the best predictive value of 30-day mortality (area under the receiver operating characteristic = .86 ± .03). The SOFA score significantly added prognostic information with regard to mortality to both SAPS II and TRISS.

Conclusions

The combination of critically ill and trauma scores may increase the accuracy of mortality prediction in multiple-trauma patients.

Keywords: Sequential Organ Failure Assessment score, Simplified Acute Physiology Score II, Multiple trauma, Outcome, Mortality, Trauma scores