Validity of SOFA score as a prognostic tool for critically ill elderly patients with acute infective endocarditis

¹ Department of Cardiology, Shenzhen Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), 518020 Shenzhen, Guangdong, China

² Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Sciences, 510650 Guangzhou, Guangdong, China

³ Department of Health Management, Shenzhen People’s Hospital, 518020 Shenzhen, Guangdong, China

^*Correspondence: szwumeishan@yeah.net (Meishan Wu); xnkdsh@yeah.net (Shaohong Dong)
Academic Editor: Takatoshi Kasai

Rev. Cardiovasc. Med. 2021, 22(3), 967–973; https://doi.org/10.31083/j.rcm2203105

Submitted: 17 May 2021 | Revised: 20 July 2021 | Accepted: 21 July 2021 | Published: 24 September 2021

(This article belongs to the Special Issue State-of-the-Art Cardiovascular Medicine in Asia 2021)

This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).

Abstract

The prognostic value of the sequential organ failure assessment (SOFA) score for critically ill elderly patients with acute infective endocarditis (IE) remains unknown. From January 2015 to December 2019, 111 elderly ( $\geq$ 65 years) patients with acute IE were consecutively included and divided into a low SOFA ( $<$ 6) group (n = 71) and a high SOFA ( $\geq$ 6) group (n = 40). Endpoints included in-hospital and long-term (12–36 month) mortality. A high SOFA score was related to higher incidence of in-hospital mortality (30.0%) with an area under the curve (AUC) of 0.796. In multivariate analysis, age [odds ratio (OR) = 2.21, 95% confidence intervals (CI), 1.16–6.79, p = 0.040], SOFA $\geq$ 6 (OR = 6.38, 95% CI, 1.80–16.89, p = 0.004) and surgical treatment (OR = 0.21, 95% CI, 0.05–0.80, p = 0.021) were predictive of in-hospital mortality. A Cox proportional-hazards model identified age [Hazard ratios (HR)= 2.85, 95% CI, 1.11–7.37, p = 0.031], diabetes mellitus (HR = 3.99, 95% CI, 1.35–11.80, p = 0.013), SOFA $\geq$ 6 (OR = 3.38, 95% CI, 1.26–9.08, p = 0.001) and surgical treatment (HR = 0.24, 95% CI, 0.08–0.68, p = 0.021) as predictors of long-term mortality. A high SOFA score predicts a poor outcome including in-hospital and long-term mortality in critically ill elderly patients with acute IE.

Keywords

SOFA

Elderly patients

Acute infective endocarditis

In-hospital mortality

Long-term mortality

Figures

Fig. 1.

Previous article in this issue

Next article in this issue

Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174