Scoring systems as risk prediction tools rely on acute
derangements in acute physiological parameters which
are numerically assigned by degree and aggregated. Such
generic (as distinct from disease-specific) scoring systems
are best exemplified by the Acute Physiology and Chronic
Health Evaluation (APACHE) system [31] which has led
to the development of a number of other organ-based
failure scores [32, 33, 34, 35].
Perhaps the most widely applied in current practice is
the Sequential Organ Failure Assessment Score (SOFA,
previously called the Sepsis-Related Organ Failure Assessment).
Daily SOFA scores provide an important physiological
tracking system for the dynamic course of critically
ill patients with sepsis. Whilst not designed for mortality
prediction, worse scores are strongly associated with mortality
[36]; the mean and highest SOFA scores are predictors
of poor prognosis, whilst a worsening of SOFA within
the first 48 h predicts the likelihood of mortality 50% or
higher [37]. However, whether organ-based scoring systems
direct the timing, degree and duration of appropriate
interventions to prevent MODS in sepsis is uncertain.
Scoring systems as risk prediction tools rely on acutederangements in acute physiological parameters whichare numerically assigned by degree and aggregated. Suchgeneric (as distinct from disease-specific) scoring systemsare best exemplified by the Acute Physiology and ChronicHealth Evaluation (APACHE) system [31] which has ledto the development of a number of other organ-basedfailure scores [32, 33, 34, 35].Perhaps the most widely applied in current practice isthe Sequential Organ Failure Assessment Score (SOFA,previously called the Sepsis-Related Organ Failure Assessment).Daily SOFA scores provide an important physiologicaltracking system for the dynamic course of criticallyill patients with sepsis. Whilst not designed for mortalityprediction, worse scores are strongly associated with mortality[36]; the mean and highest SOFA scores are predictorsof poor prognosis, whilst a worsening of SOFA withinthe first 48 h predicts the likelihood of mortality 50% orhigher [37]. However, whether organ-based scoring systemsdirect the timing, degree and duration of appropriateinterventions to prevent MODS in sepsis is uncertain.
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