The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department
Background: The Sequential Organ Failure Assessment (SOFA) score is currently the primary prognostic tool used in patients with infections to predict sepsis and mortality, although its predictive role remains debated. Serum albumin values have been recently found to correlate with the severity of se...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7676 |
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| author | Gianni Turcato Arian Zaboli Serena Sibilio Michael Mian Francesco Brigo |
| author_facet | Gianni Turcato Arian Zaboli Serena Sibilio Michael Mian Francesco Brigo |
| author_sort | Gianni Turcato |
| collection | DOAJ |
| description | Background: The Sequential Organ Failure Assessment (SOFA) score is currently the primary prognostic tool used in patients with infections to predict sepsis and mortality, although its predictive role remains debated. Serum albumin values have been recently found to correlate with the severity of sepsis. The purpose of this study is to evaluate the clinical usefulness of albumin dosage on SOFA score prediction in infected patients. Methods: This prospective single-centre observational study was performed in 2021. We used the net reclassification improvement (NRI) technique to evaluate the additional prognostic value of serum albumin used together with the SOFA score in infected patients. The discriminatory abilities of the SOFA score alone, of albumin levels alone, and of the albumin levels together with (but not incorporated into) the SOFA score was evaluated by comparing the area under the curve of the corresponding receiver operating characteristic (ROC) curves. Results: We included 949 patients with an infectious status; 8.9% (84/949) died within 30 days of ED admission. The AUROC for the SOFA score was 0.802 (95% CI: 0.756–0.849) and the albumin level was 0.813 (95% CI: 0.775–0.852). The NRI found that serum albumin improved SOFA score predictions of 30-day mortality by 24.3% (<i>p</i> < 0.001), yielding an AUROC of 0.881 (95% CI: 0.848–0.912; <i>p</i> < 0.001). Conclusions: Using serum albumin values together with the SOFA score can improve prognostic prediction in patients with infections evaluated in the ED. |
| first_indexed | 2024-03-08T20:39:04Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:39:04Z |
| publishDate | 2023-12-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9c6fba8582104997a2d1efe1a05840a72023-12-22T14:17:25ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224767610.3390/jcm12247676The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency DepartmentGianni Turcato0Arian Zaboli1Serena Sibilio2Michael Mian3Francesco Brigo4Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), 36014 Santorso, ItalyInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Via A. Volta 5, 39049 Bolzano, ItalyDepartment of Emergency Medicine, Hospital of Merano-Meran (SABES-ASDAA), 39012 Merano-Meran, ItalyInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Via A. Volta 5, 39049 Bolzano, ItalyInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Via A. Volta 5, 39049 Bolzano, ItalyBackground: The Sequential Organ Failure Assessment (SOFA) score is currently the primary prognostic tool used in patients with infections to predict sepsis and mortality, although its predictive role remains debated. Serum albumin values have been recently found to correlate with the severity of sepsis. The purpose of this study is to evaluate the clinical usefulness of albumin dosage on SOFA score prediction in infected patients. Methods: This prospective single-centre observational study was performed in 2021. We used the net reclassification improvement (NRI) technique to evaluate the additional prognostic value of serum albumin used together with the SOFA score in infected patients. The discriminatory abilities of the SOFA score alone, of albumin levels alone, and of the albumin levels together with (but not incorporated into) the SOFA score was evaluated by comparing the area under the curve of the corresponding receiver operating characteristic (ROC) curves. Results: We included 949 patients with an infectious status; 8.9% (84/949) died within 30 days of ED admission. The AUROC for the SOFA score was 0.802 (95% CI: 0.756–0.849) and the albumin level was 0.813 (95% CI: 0.775–0.852). The NRI found that serum albumin improved SOFA score predictions of 30-day mortality by 24.3% (<i>p</i> < 0.001), yielding an AUROC of 0.881 (95% CI: 0.848–0.912; <i>p</i> < 0.001). Conclusions: Using serum albumin values together with the SOFA score can improve prognostic prediction in patients with infections evaluated in the ED.https://www.mdpi.com/2077-0383/12/24/7676infectionSOFAsepsisemergency medicinealbuminSequential Organ Failure Assessment |
| spellingShingle | Gianni Turcato Arian Zaboli Serena Sibilio Michael Mian Francesco Brigo The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department Journal of Clinical Medicine infection SOFA sepsis emergency medicine albumin Sequential Organ Failure Assessment |
| title | The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department |
| title_full | The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department |
| title_fullStr | The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department |
| title_full_unstemmed | The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department |
| title_short | The Clinical Utility of Albumin with Sequential Organ Failure Assessment (SOFA) in Improving 30-Day Mortality Prediction in Patients with Infection in the Emergency Department |
| title_sort | clinical utility of albumin with sequential organ failure assessment sofa in improving 30 day mortality prediction in patients with infection in the emergency department |
| topic | infection SOFA sepsis emergency medicine albumin Sequential Organ Failure Assessment |
| url | https://www.mdpi.com/2077-0383/12/24/7676 |
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