Résumé :
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[BDSP. Notice produite par INIST-CNRS QDR0xMV5. Diffusion soumise à autorisation]. Context Evaluation of trends in organ dysfunction in critically ill patients may help predict outcome. Objective To determine the usefulness of repeated measurement the Sequential Organ Failure Assessment (SOFA) score for prediction of mortality in intensive care unit (ICU) patients. Design Prospective, observational cohort study conducted from April 1 to July 31,1999. Setting A 31-bed medicosurgical ICU at a university hospital in Belgium. Patients Three hundred fifty-two consecutive patients (mean age, 59 years) admitted to the ICU for more than 24 hours for whom the SOFA score was calculated on admission and every 48 hours until discharge. Main Outcome Measures Initial SOFA score (0-24), delta-SOFA scores (differences between subsequent scores), and the highest and mean SOFA scores obtained during the ICU stay and their correlations with mortality. Results The initial, highest, and mean SOFA scores correlated well with mortality. Initial and highest scores of more than 11 or mean scores of more than 5 corresponded to mortality of more than 80%. The predictive value of the mean score was independent of the length of ICU stay. In univariate analysis, mean and highest SOFA scores had the strongest correlation with mortality, followed by delta-SOFA and initial SOFA scores. The area under the receiver operating characteristic curve was largest for highest scores (0.90 ; SE, 0.02 ; P<. vs initial score when analyzing trends in the sofa during first hours regardless of mortality rate was at least increased to it remained unchanged and less than decreased. differences were better predicted subsequent hours. there no significant difference length stay among these groups.>
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