Comparison of Sequential Organ Failure Assessment (SOFA) and Sepsis in Obstetrics Score (SOS) in Women with Pregnancy-As
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ORIGINAL ARTICLE
Comparison of Sequential Organ Failure Assessment (SOFA) and Sepsis in Obstetrics Score (SOS) in Women with Pregnancy‑Associated Sepsis with Respect to Critical Care Admission and Mortality: A Prospective Observational Study Rachna Agarwal1 · Penzy Goyal1 · Medha Mohta2 · Rajarshi Kar3 Received: 17 March 2020 / Accepted: 2 September 2020 © Federation of Obstetric & Gynecological Societies of India 2020
Abstract Objective We aimed to determine performance of sequential organ failure assessment (SOFA) and Sepsis in Obstetrics Score (SOS), in women with pregnancy-associated sepsis (PAS) with respect to critical care admission and mortality. Methods Obstetric patients with PAS fulfilling any 2 of the quick SOFA (qSOFA) criteria were enrolled as cases. The various parameters of SOFA and SOS were recorded at admission and compared for outcomes. Results Critical care was required in 32 (50.7%) patients and associated mortality was high (31.7%). For our study population, a threshold of SOFA ≥ 6 had the best combination of sensitivity (84.4%) and specificity (61.3%) for critical care admission. For SOS, a cut-off value of ≥ 6 gave best sensitivity (64%) and specificity (40%) for the same. Conclusions SOFA was far more predictive of patient’s critical condition as well as mortality compared to SOS. SOFA was superior to SOS in determining critical care admission and mortality for PAS. Keywords SOFA · SOS · Obstetric sepsis · Pregnancy-associated sepsis
Introduction Dr. Rachna Agarwal, MS (Obstetrics & Gynaecology) is Professor at Department of Obstetrics & Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India; Dr. Penzy Goyal, MBBS is Postgraduate student at Department of Obstetrics & Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India; Dr. Medha Mohta, MD (Anaesthesia) is Director Professor at Department of Anaesthesia, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India; Dr. Rajarshi Kar, MD (Biochemistry) is Associate Professor, Department of Biochemistry, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. * Rachna Agarwal [email protected] 1
Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
2
Department of Anaesthesia, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
3
Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India
Pregnancy-associated sepsis (PAS) is responsible for significant maternal morbidity and mortality world over. Even in high-income nations, pregnancy-associated sepsis complicates approximately 4–10 per 10,000 live births [1, 2]. In a report from UK, sepsis was responsible for nearly a quarter of maternal deaths, the chief reasons being delay in recognition or management [3]. Sepsis overall and specifically PAS have been on the priority
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