The Sequential Organ Failure Assessment (SOFA) score predicts mortality and neurological outcome in patients with post-cardiac arrest syndrome

Junji Matsuda; Shunichi Kato; Hirotaka Yano; Giichi Nitta; Toshikazu Kono; Takashi Ikenouchi; Kazuya Murata; Miki Kanoh; Yukihiro Inamura; Tomomasa Takamiya; Ken Negi; Akira Sato; Tsunehiro Yamato; Osamu Inaba; Hideki Morita; Yutaka Matsumura; Junichi Nitta; Taishi Yonetsu

doi:10.1016/j.jjcc.2020.03.007

The Sequential Organ Failure Assessment (SOFA) score predicts mortality and neurological outcome in patients with post-cardiac arrest syndrome

J Cardiol. 2020 Sep;76(3):295-302. doi: 10.1016/j.jjcc.2020.03.007. Epub 2020 Apr 16.

Authors

Junji Matsuda¹, Shunichi Kato², Hirotaka Yano², Giichi Nitta², Toshikazu Kono², Takashi Ikenouchi², Kazuya Murata², Miki Kanoh², Yukihiro Inamura², Tomomasa Takamiya², Ken Negi², Akira Sato², Tsunehiro Yamato², Osamu Inaba², Hideki Morita³, Yutaka Matsumura², Junichi Nitta⁴, Taishi Yonetsu⁵

Affiliations

¹ Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan; Department of Cardiovascular Surgery, Japanese Red Cross Saitama Hospital, Saitama, Japan. Electronic address: reds.no.reds@hotmail.co.jp.
² Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan.
³ Department of Cardiovascular Surgery, Japanese Red Cross Saitama Hospital, Saitama, Japan.
⁴ Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
⁵ Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

PMID: 32305260
DOI: 10.1016/j.jjcc.2020.03.007

Abstract

Background: Patients experiencing out-of-hospital cardiac arrest (OHCA) and subsequent post-cardiac arrest syndrome are often compromised by multi-organ failure. The Sequential Organ Failure Assessment (SOFA) score has been used to predict clinical outcome of patients requiring intensive care for multi-organ failure. Thus, the assessment of SOFA score is recommended as a criterion for sepsis. Although post-cardiac arrest patients frequently develop sepsis-like status in ICU, there are limited reports evaluating the SOFA score in post-cardiac arrest patients. We investigated the predictive value of the SOFA score in survival and neurological outcomes in patients with post-cardiac arrest syndrome.

Methods: A total of 231 cardiovascular arrest patients achieving return of spontaneous circulation (ROSC) were finally extracted from the institutional consecutive database comprised of 1218 OHCA patients transferred to the institution between January 2015 and July 2018. The SOFA score was calculated on admission and after 48h. Predictors of survival and neurological outcome defined as having cerebral-performance-category (CPC) 1 or 2 at 30 days were determined.

Results: SOFA score was lower in survived patients (5.0 vs 10.0, p<0.001) and those with favorable neurological outcome (5.0 vs 8.0, p<0.001) as compared with the counterparts. The SOFA score on admission was an independent predictor of survival (OR 0.68, 95% confidence interval [CI] 0.59-0.78; p<0.001) and favorable neurological performance (OR 0.79; 95% CI 0.69-0.90; p<0.001) at 30 days. Furthermore, a change in SOFA score (48-0h) was predictive of favorable 30-day neurological outcome (OR 0.71, 95% CI 0.60-0.85; p<0.001).

Conclusions: Evaluation of the SOFA score in the ICU is useful to predict survival and neurological outcome in post-cardiac arrest patients.

Keywords: Neurological outcome; Out-of-hospital cardiac arrest; Post-cardiac arrest syndrome; Sequential Organ Failure Assessment score.

Publication types

Evaluation Study

MeSH terms

Aged
Female
Humans
Male
Middle Aged
Multiple Organ Failure / etiology
Multiple Organ Failure / mortality*
Nervous System Diseases / etiology*
Organ Dysfunction Scores*
Out-of-Hospital Cardiac Arrest / complications*
Post-Cardiac Arrest Syndrome / etiology
Post-Cardiac Arrest Syndrome / mortality*
Predictive Value of Tests
Prognosis