每日序贯器官衰竭评估（SOFA）-2分对30天死亡率的预测有效性
Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality.
摘要(中文译文)
最近更新了序贯器官衰竭评估（SOFA）评分，以更好地反映当代重症监护。本研究比较了更新的SOFA-2和之前的SOFA-1对ICU第一周30天死亡率的预测有效性，包括总体和具有不同年龄和共病特征的亚组。我们对2010年至2021年瑞典四个ICU收治的成年患者进行了回顾性观察研究。使用受试者工作特征曲线下面积（AUROC）在第1-7天评估30天死亡率的预测有效性。我们纳入了29820名入院患者（平均年龄60岁，64.8%为男性，Charlson共病指数中位数[CCI]1）。在第1-7天，75-79%的入院患者发生了SOFA-1和SOFA-2之间的重新分类。在第1天，SOFA-2和SOFA-1的30天死亡率AUROC分别为0.81（95%CI 0.80-0.81）和0.80（95%CI 0.79-0.81）（p < 0.001). 从第2天开始，这两个分数的AUROC都有所下降，并且基本相似。在创伤患者（平均年龄50岁；中位数CCI 0）中，SOFA-2的第一天AUROC为0.81（95%CI 0.79-0.83），而在败血症患者（平均岁61岁；中位数CCI3）中，AUROC是0.72（95%CI 0.7-0.74），SOFA-1的表现相当。与SOFA-1相比，SOFA-2在ICU第1天对30天死亡率的区分能力略强。在随后的几天里，这两个评分的预测有效性都有所下降，并且在不同年龄和共病分布的亚组之间存在差异，这突显了器官功能障碍评分的情境依赖性。https://doi.org/10.5281/zenodo.17651826，注册日期2025年11月19日。
Abstract
The sequential organ failure assessment (SOFA) score was recently updated to better reflect contemporary intensive care. This study compares the predictive validity of the updated SOFA-2 and the previous SOFA-1 for 30-day mortality over the first week in ICU, overall and in subgroups with distinct age and comorbidity profiles. We conducted a retrospective observational study of adult patients admitted to four ICUs in Sweden from 2010 to 2021. Predictive validity for 30-day mortality was assessed on day 1-7 using the area under the receiver operating characteristic curve (AUROC). We included 29,820 admissions (mean age 60 years, 64.8% males, median Charlson comorbidity index [CCI] 1). Reclassification between SOFA-1 and SOFA-2 occurred in 75-79% of admissions across days 1-7. On day 1, the AUROC for 30-day mortality was 0.81 (95% CI 0.80-0.81) for SOFA-2 and 0.80 (95% CI 0.79-0.81) for SOFA-1 (p < 0.001). From day 2 onward, AUROCs declined for both scores and were largely similar. Among trauma patients (mean age 50 years; median CCI 0), day-1 AUROC for SOFA-2 was 0.81 (95% CI 0.79-0.83), while among sepsis patients (mean age 61 years; median CCI 3) it was 0.72 (95% CI 0.70-0.74), with comparable performance for SOFA-1. SOFA-2 provided modestly better discrimination for 30-day mortality on ICU-day 1 compared with SOFA-1. Predictive validity diminished over subsequent days for both scores and varied across subgroups with different age and comorbidity distributions, underscoring the context-dependence of organ dysfunction scoring. https://doi.org/10.5281/zenodo.17651826 , registration date November 19, 2025.
如何引用
AMA
Johan Helleberg, Anna Sundelin, Navid Soltani, Olav Rooyackers, Johan Mårtensson. Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality.. Critical care (London, England). 2026; doi:10.1186/s13054-026-06093-8.
APA
Johan Helleberg, Anna Sundelin, Navid Soltani, Olav Rooyackers, Johan Mårtensson (2026). Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality.. Critical care (London, England). https://doi.org/10.1186/s13054-026-06093-8
GB/T 7714
Johan Helleberg, Anna Sundelin, Navid Soltani, Olav Rooyackers, Johan Mårtensson. Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality.[J]. Critical care (London, England), 2026 doi:10.1186/s13054-026-06093-8.
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