N. Shime et al., Application of modified sequential organ failure assessment score in children after cardiac surgery, J CARDIOTHO, 15(4), 2001, pp. 463-468
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.