Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA.
J Crit Care. 2012 Dec;27(6):673-80. doi: 10.1016/j.jcrc.2012.04.018. Epub 2012 Jul 2.
This study aims to validate the performance of the Sequential Organ Failure Assessment (SOFA) score to predict death of critically ill patients with cancer.
We conducted a retrospective observational study including adults admitted to the intensive care unit (ICU) between January 1, 2006, and December 31, 2008. We randomly selected training and validation samples in medical and surgical admissions to predict ICU and in-hospital mortality. By using logistic regression, we calculated the probabilities of death in the training samples and applied them to the validation samples to test the goodness-of-fit of the models, construct receiver operator characteristics curves, and calculate the areas under the curve (AUCs).
In predicting mortality at discharge from the unit, the AUC from the validation group of medical admissions was 0.7851 (95% confidence interval [CI], 0.7437-0.8264), and the AUC from the surgical admissions was 0.7847 (95% CI, 0.6319-0.937). The AUCs of the SOFA score to predict mortality in the hospital after ICU admission were 0.7789 (95% CI, 0.74-0.8177) and 0.7572 (95% CI, 0.6719-0.8424) for the medical and surgical validations groups, respectively.
The SOFA score had good discrimination to predict ICU and hospital mortality. However, the observed underestimation of ICU deaths and unsatisfactory goodness-of-fit test of the model in surgical patients to indicate calibration of the score to predict ICU mortality is advised in this group.
本研究旨在验证序贯器官衰竭评估（SOFA）评分对预测癌症重症患者死亡的性能。
我们进行了一项回顾性观察性研究，纳入 2006 年 1 月 1 日至 2008 年 12 月 31 日期间入住重症监护病房（ICU）的成年人。我们随机选择了内科和外科入院患者的训练和验证样本，以预测 ICU 和院内死亡率。通过逻辑回归，我们计算了训练样本中死亡的概率，并将其应用于验证样本中，以检验模型的拟合优度，构建受试者工作特征曲线，并计算曲线下面积（AUC）。
在预测从 ICU 出院时的死亡率方面，内科验证组的 AUC 为 0.7851（95%置信区间[CI]，0.7437-0.8264），外科验证组的 AUC 为 0.7847（95%CI，0.6319-0.937）。SOFA 评分预测 ICU 后住院死亡率的 AUC 分别为内科验证组 0.7789（95%CI，0.74-0.8177）和外科验证组 0.7572（95%CI，0.6719-0.8424）。
SOFA 评分对预测 ICU 和院内死亡率具有良好的区分能力。然而，观察到 ICU 死亡的低估以及外科患者模型拟合优度测试不理想，表明需要对该评分进行校准以预测 ICU 死亡率。
