What's my mother's SOFA today, doc? Commentary on: Daily evaluation of organ function during renal replacement therapy in ICU patients with acute renal failure.

摘要

In this issue of the Journal of Critical Care Medicine, Dr Vincent discusses a validation of the daily Sequential Organ Failure Assessment (SOFA) score as an outcome predictor in intensive care unit (ICU) patients with acute renal failure (ARF) who are receiving renal replacement therapy. In this retrospective study of 111 patients, he reports that non-survivors are older and have higher initial scores for SOFA respiratory, cardiovascular, and total. Furthermore, he goes on to note that the SOFA cardiovascular remained higher in nonsurvivors up to 7 days after ICU admission. Multivariate analysis, wherein ICU outcome was the dependent variable, confirmed that age, initial SOFA cardiovascular, and change in the SOFA total over the first 24 hours were independently associated with mortality. He concludes by suggesting that serial measurements of the SOFA score in this patient population will assist the clinician in identifying patients unlikely to benefit from this expensive therapy.