There are many prognostic models and scoring systems in use to predict mortality in ICU patients. The only general ICU scoring system developed and validated for patients after cardiac surgery is the APACHE-IV model. This is, however, a labor-intensive scoring system requiring a lot of data and could therefore be prone to error. The SOFA score on the other hand is a simpler system, has been widely used in ICUs and could be a good alternative. The goal of the study was to compare the SOFA score with the APACHE-IV and other ICU prediction models. We investigated, in a large cohort of cardiac surgery patients admitted to Dutch ICUs, how well the SOFA score from the first 24 h after admission, predict hospital and ICU mortality in comparison with other recalibrated general ICU scoring systems. Measures of discrimination, accuracy, and calibration (area under the receiver operating characteristic curve (AUC), Brier score, R2, and Ĉ-statistic) were calculated using bootstrapping. The cohort consisted of 36,632 Patients from the Dutch National Intensive Care Evaluation (NICE) registry having had a cardiac surgery procedure for which ICU admission was necessary between January 1st, 2006 and June 31st, 2018. Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict hospital mortality was good with an AUC of respectively: 0.809, 0.851, 0.830, 0.850, 0.801. Discrimination of the SOFA-, APACHE-IV-, APACHE-II-, SAPS-II-, MPM24-II - models to predict ICU mortality was slightly better with AUCs of respectively: 0.809, 0.906, 0.892, 0.919, 0.862. Calibration of the models was generally poor. Although the SOFA score had a good discriminatory power for hospital- and ICU mortality the discriminatory power of the APACHE-IV and SAPS-II was better. The SOFA score should not be preferred as mortality prediction model above traditional prognostic ICU-models.

中文翻译：

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心脏手术后ICU患者的SOFA评分预测死亡率；与传统的预后模型进行比较。

有许多预测模型和评分系统可用于预测ICU患者的死亡率。为心脏手术后的患者开发和验证的唯一通用ICU评分系统是APACHE-IV模型。但是，这是一个劳动密集的计分系统，需要大量数据，因此容易出错。另一方面，SOFA评分是一个简单的系统，已在ICU中广泛使用，可能是一个很好的选择。该研究的目的是将SOFA评分与APACHE-IV和其他ICU预测模型进行比较。我们在一大批接受荷兰ICU的心脏外科手术患者中，调查了入院后24小时内SOFA评分与其他经过重新校准的一般ICU评分系统相比，预测医院和ICU死亡率的情况。区分度，准确性，使用自举法计算和校准（接收器工作特征曲线（AUC）下的面积，Brier得分，R2和Ĉ统计量）。该队列包括来自荷兰国家重症监护评估（NICE）登记册的36,632名患者，他们在2006年1月1日至2018年6月31日期间进行了心脏手术，必须接受ICU手术。SOFA-，APACHE-IV- ，APACHE-II-，SAPS-II-，MPM24-II-预测医院死亡率的模型良好，AUC分别为：0.809、0.851、0.830、0.850、0.801。预测ICU死亡率的SOFA-，APACHE-IV-，APACHE-II-，SAPS-II-，MPM24-II模型的判别率略好于AUC：0.809、0.906、0.892、0.919、0.862。模型的校准通常很差。尽管SOFA评分对医院和ICU的死亡率具有很好的判别力，但APACHE-IV和SAPS-II的判别力更好。SOFA评分不应作为死亡率预测模型，而不是传统的预后ICU模型。