Application of modified sequential organ failure assessment score in children after cardiac surgery

Objective: To evaluate the usefulness of the modified sequential organ fail ure assessment (m/SOFA) score for assessing morbidity and mortality in pedi atric patients after cardiac surgery. Design: Analysis of a prospectively collected database. Setting: Pediatric intensive care unit of a university-affiliated hospital. Participants: Consecutive pediatric patients (n = 142) undergoing cardiac s urgery. Interventions: None. Measurements and Main Results: The m/SOFA score, consisting of 5 organ scor es (maximum score of 20 points), was calculated on admission (initial) and at 12 and 36 hours postoperatively. An initial score of > 5 points with an unchanged or upward postoperative trend predicted a higher postoperative mo rtality and a greater need for intensive care intervention. In neonates, su stained higher score > 10 points predicted an outcome of death with a sensi tivity of 100% and a specificity of 87%. Given the higher mortality related to immature organ function and a greater complexity of heart defects, the application of the m/SOFA score, a less invasive and simple way to assess o rgan damage, is especially suitable in neonates. The m/SOFA score would be more appropriately assessed according to the congenital heart defect or sur gical procedure because the types of cardiac defect after the surgical repa ir affect each organ score measurement. Conclusion: Application of the m/SOFA score in the early postoperative peri od, which reflects cumulative perioperative organ damage, would provide som e direction to eventual outcomes of morbidity and mortality in patients wit h congenital heart defects undergoing surgery. Copyright (C) 2001 by W.B. S aunders Company.