Evaluation of the performance of disease severity indices (SOFA, SAPS III, and MPM II) for the prediction of mortality rate in COVID-19 patients admitted to the intensive care units: a retrospective cross-sectional study.

BACKGROUND

The COVID-19 pandemic created a high demand for hospital beds and intensive care, which led to the collapse of healthcare systems. Therefore, it is critical to identify factors associated with increased mortality in patients to prioritize high-risk individuals.

AIM

Given the potential for similar pandemics in the future, this study investigated predictors of mortality in ICU patients with COVID-19 and their correlation with mortality rates.

STUDY DESIGN

In this retrospective study, all patients admitted to the ICUs of Ghaem and Imam Reza tertiary hospitals in Mashhad with a definitive diagnosis of COVID-19 from March 21, 2020, to December 1, 2021, were evaluated for disease severity assessment criteria, including SOFA, SAPS III, and MPM II.

RESULTS

One hundred seventy-two patients with COVID-19 who were admitted to the ICU were evaluated (147 patients in the non-survivor group and 25 patients in the survivor group. The median SAPS, SOFA, and MPM scores were significantly higher in non-survivors (p<0.001 in all cases). Higher SAPS, SOFA, and MPM were associated with an increased risk of mortality in COVID-19 patients in the ICU. The best cut-off points for the three scoring systems, SAPS, SOFA, and MPM, were 39, 6, and 13.7, respectively. The AUC value of the SOFA score was significantly higher than the SAPS (P = 0.0274) and MPM (P = 0.0209) scores.

CONCLUSION

COVID-19 patients admitted to the ICU with higher SOFA, MPM, and SAPS scores suffered from higher mortality rates. Because the SOFA score showed high predictive accuracy, this scoring system should be considered a priority as an essential tool in triaging and managing critically ill COVID-19 patients.