Weng Chao, Yu Cong, Yang Guang-Wei, Jiang Jin-Song, Wu Hao
General Surgery, Cancer Center, Department of Vascular Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
PLoS One. 2025 Jan 3;20(1):e0314137. doi: 10.1371/journal.pone.0314137. eCollection 2025.
This retrospective study aimed to explore the association and clinical value of sequential organ failure assessment (SOFA) score on the predictors of adverse events in patients with unruptured abdominal aortic aneurysms (AAA).
A total of 322 patients from Medical Information Mart for Intensive Care IV database were enrolled. Logistic regression was conducted to explore the association between SOFA and primary outcome (need for surgery, NFS). Receiver operating characteristic (ROC) and nomogram analyses were used to assess its performance for predicting NFS. We also explored the association and clinical value of SOFA on secondary outcomes including hospital length of stay (LOS), ICU-LOS, and in-hospital mortality by linear and logistic regression analyses, generalized additive model, ROC, and decision curve analysis.
Totally 291 patients underwent the surgery. High SOFA score significantly correlated with NFS both in crude and adjusted models (all P<0.05). SOFA had a relatively favorable prediction performance on NFS (AUC = 0.701, 95%CI: 0.596-0.802). After adjusting for related diseases, its prediction performance was increased. When SOFA was combined with lactate and gender, the model showed an AUC of 0.888 (95%CI: 0.759-1.000) and 0.3-0.9 prediction possibility. Further, the SOFA also showed significant relationship with hospital-LOS, ICU-LOS, and in-hospital mortality (all P<0.05), and exerted some value in the prediction of 7-day hospital-LOS (AUC = 0.637, 95%CI: 0.575-0.686) and in-hospital mortality (AUC = 0.637, 95%CI: 0.680-0.845).
SOFA score was related to the NFS and can be regarded as a useful indicator for predicting the NFS in patients with AAA.
本回顾性研究旨在探讨序贯器官衰竭评估（SOFA）评分与未破裂腹主动脉瘤（AAA）患者不良事件预测因素之间的关联及临床价值。
纳入重症监护医学信息数据库IV中的322例患者。进行逻辑回归分析以探讨SOFA与主要结局（手术需求，NFS）之间的关联。采用受试者工作特征（ROC）曲线和列线图分析评估其预测NFS的性能。我们还通过线性和逻辑回归分析、广义相加模型、ROC曲线和决策曲线分析，探讨了SOFA与次要结局（包括住院时间（LOS）、ICU住院时间、院内死亡率）之间的关联及临床价值。
共有291例患者接受了手术。在粗模型和校正模型中，高SOFA评分均与NFS显著相关（所有P<0.05）。SOFA对NFS具有相对良好的预测性能（AUC = 0.701，95%CI：0.596 - 0.802）。校正相关疾病后，其预测性能有所提高。当SOFA与乳酸和性别相结合时，模型的AUC为0.888（95%CI：0.759 - 1.000），预测可能性为0.3 - 0.9。此外，SOFA还与住院LOS、ICU-LOS和院内死亡率显著相关（所有P<0.05），并在预测7天住院LOS（AUC = 0.637，95%CI：0.575 - 0.686）和院内死亡率（AUC = 0.637，95%CI：0.680 - 0.845）方面具有一定价值。
SOFA评分与NFS相关，可被视为预测AAA患者NFS的有用指标。
