SOFA score to assess the severity of the post-cardiac arrest syndrome

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• 作者：Martin Cour^a ; ^b ; ^c ; ^{martin.cour@chu-lyon.fr" class="auth_mail" title="E-mail the corresponding author} ; Didier Bresson^a ; ^b ; ^{didierbresson01@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Romain Hernu^a ; ^b ; ^{romain.hernu@chu-lyon.fr" class="auth_mail" title="E-mail the corresponding author} ; Laurent Argaud^a ; ^b ; ^c ; ^{laurent.argaud@chu-lyon.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Out-of-hospital cardiac arrest ; Post-cardiac arrest syndrome ; Cardiopulmonary resuscitation ; Outcome assessment ; SOFA score ; Multiple organ failure
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：102
• 期：Complete
• 页码：110-115
• 全文大小：308 K

文摘

The aim of the study was to assess the prognostic impact of organ failures at ICU admission after out-of-hospital cardiac arrest (CA) according to the SOFA score.

Methods

We performed a retrospective analysis of a prospective cohort of all adult patients admitted to a 15-bed medical ICU in a university-affiliated hospital after an out-of-hospital CA. In addition to demographic and clinical data, initial illness severity was measured using the SOFA score. Outcomes (mortality and neurological prognosis) were also collected at day 28 and one year.

Results

A total of 304 patients (age: 66 ± 16 years, male: 55%) were admitted for post-CA management. An initial nonshockable cardiac rhythm was recorded in 274 (90%) cases. At admission, SOFA score averaged 9.8 ± 3.1 for the entire cohort (8.1 ± 3.3 for day 28 survivors versus 10.1 ± 3.1 for non-survivors, p < 0.001). At day 1, SOFA remained significantly (p < 0.001) higher in nonsurvivors (9.8 ± 3.8) when compared to survivors (6.5 ± 4.1). Death occurred in 269 (88%) and 275 (90%) patients within the 28-day and one-year period, respectively. Neurological outcome at one year was favorable (CPC score 1–2) in 23patients (8%). Multivariate analysis identified the SOFA score at admission as independently associated with mortality at day28 (OR per point of SOFA score 1.17; 95% CI 1.01–1.35; p = 0.03).

Conclusions

In the present study, early organ failures, as assessed by the SOFA score at ICU admission, were independently associated with day 28 mortality. SOFA score may help clinicians objectively evaluate the severity of the post-CA syndrome.