Authors : Rupa M. Mascarenhas, Reshmina Clara D'Souza, Shafeel Ibrahim K, Sheldon Mathias, Mohammed Ashfaque
DOI : 10.18231/j.ijashnb.2019.016
Volume : 5
Issue : 2
Year : 2019
Page No : 61-63
The morbidity of life threatening infection is reflected by the Multiple Organ Dysfunction Syndrome (MODS), so reliable methods of assessing MODS are an important pre requisite for the evaluation and treatment of patients with sepsis. The usefulness of the sofa score has previously been validated in large cohorts of critically ill patients. It was even used as a mortality predictor and compared with other scoring systems such as APACHE. However none of the studies have used it on patients with surgical sepsis. In this study the trend of sofa scoring and its derivatives is compared in patients with surgical sepsis. All the patients were appropriately assessed and managed according to standard guidelines for the respective disease.
Materials and Methods: A prospective, non interventional study was done on multiple centres in the district of Dakshina Kannada on 120 adult patients admitted in who either presented with, or were in sepsis at the time of first examination. Between June 2018 to May 2019. The SOFA score was collected on a daily basis. The worst value of each day was taken. The score was calculated till discharge from ICU, mortality or day 5 of admission to ICU whichever was earliest.
Results: Among 120 patients who were included in the study, majority in the surgical group were Exploratory Laprotomies secondary to Hollow viscus perforation, Diabetic foot and Necrotising fasciitis. In the NON surgical group were pneumonia, acute exacerbation of COPD, urosepsis, viral hemorrhagic fevers. A prolonged ICU stay could be predicted at the time of admission on the basis of the dysfunction of those organ systems that generally require more prolonged ICU support, that is, cardiovascular, respiratory, and neurologic systems.
Conclusion: For management, mean and maximum score help determine the severity of illness and can act as a guide for the intensity of therapy required for each patient.
Keywords: MODS, ICU.