THE SEQUENTIAL ORGAN FAILURE ASSESSMENT (SOFA) SCORE IN PREDICTING MORTALITY IN CRITICAL DOGS

Introduction: The Sequential Organ Failure Assessment (SOFA) score is an organ dysfunction scoring system used to assess critically ill patients. Objective: To evaluate the correlation between the SOFA scores at the time of arrival and with outcome in critical patients in a veterinary ICU. Methods: 689 clinical records of dogs, aged more than 1 year, red or yellow emergency code, were examined for the applicability of the SOFA score. Inclusion criteria were related to the presence of data required for the applicability of the SOFA score. Animals were divided in survival (S) and non-survival (NS) and data were analysed with a Mann–Whitney test. Patients were than divided in two subgroups: adult (1 to 8 years) and old (more than 8 years). A ROC test was performed to evaluate the sensitivity and specificity and the Youden’s index was calculated to find the best cut-off. P- values < 0.05 were considered significant. Results: 112 records met all the inclusion criteria. The median (range) SOFA score for patients that survived was 2 (0–9) which was significantly lower than non-survival 5.5 (0–14). The median (range) SOFA score in the NS was 6.5 (0-14) and 5 (0–9) for adult and old respectively. The best cut-off score was 5.5 with a sensitivity of 56.6% and a specificity of 92.8%; all the scores > 9.5 resulted in a specificity of 100%. Discussion: This study revealed a good predictive capability of the SOFA score in the ICU setting. A cut-off score of 5.5 produced a non-favorable outcome and scores over 9.5 were strictly connected to death. SOFA scores lower than 3 were associated with a good outcome. Old dogs had negative outcome with lower scores in comparison to adult dogs. Conclusions: The SOFA scoring system resulted a useful tool to predict the outcome of critical dogs.