What is the clinical evidence from this study?

Study design: Cohort. Population: Critically ill patients (n=65366). Intervention: SOFA-2 vs. SOFA-1. Primary outcome: ICU mortality (AUROC) (95% CI 0.823-0.835).

What does this research mean for the field?

The SOFA-2 score demonstrates superior discrimination for ICU and in-hospital mortality compared with the SOFA-1 score in critically ill patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim is to validate the SOFA-2 score's effectiveness compared to SOFA-1 in predicting mortality for critically ill patients.

March 26, 2026Open Access

SOFA-2 versus SOFA-1 for mortality prediction in critically ill patients

Resultado clave

SOFA-2 demonstrated superior discrimination for ICU mortality compared with SOFA-1 (AUROC 0.829 vs 0.796) in critically ill patients.

Puntos clave

The aim is to validate the SOFA-2 score's effectiveness compared to SOFA-1 in predicting mortality for critically ill patients.
Analyzed 65,366 patients from the MIMIC-IV database
Compared SOFA-1 and SOFA-2 scores
Calculated area under the receiver operating characteristic (AUROC) for mortality rates
Assessed the reclassification of patients between scores
SOFA-2 had an AUROC of 0.829 for ICU mortality compared to 0.796 for SOFA-1
For in-hospital mortality, SOFA-2's AUROC was 0.789 against SOFA-1's 0.763
62.7% of patients were reclassified to higher scores under SOFA-2
Higher SOFA-2 scores correlated with increased ICU mortality rates across SOFA-1 strata

Diseño del estudio

Tipo

Cohort (n=65,366)

Multicéntrico

PICO estructurado

Does the SOFA-2 score improve mortality prediction compared to SOFA-1 in critically ill patients?

Población

Critically ill adult patients (≥ 18 years) with their first ICU admission, median age 66, 56.2% male

Intervención

SOFA-2 score

Comparador

SOFA-1 score

Resultado

ICU mortalityhard clinical

SOFA-2 provides superior discrimination over SOFA-1 for predicting ICU mortality in a high-acuity US cohort, supporting its broad applicability in critical care.

Resultado numérico

Tasa de eventos absoluta: 0.829% vs 0.796%

Limitaciones

Single-center, retrospective design
Assessed only a single time point

Resumen

We validated the SOFA-2 score against the SOFA-1 score using 65,366 critically ill patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. SOFA-2 demonstrated superior discrimination for ICU mortality (AUROC: 0.829 95% CI 0.823–0.835 vs. 0.796 0.789–0.803) and in-hospital mortality (0.789 0.783–0.794 vs. 0.763 0.757–0.769) compared with SOFA-1. Of 65,366 patients, 40,990 (62.7%) were reclassified to higher scores under SOFA-2. Within each SOFA-1 stratum, those assigned higher SOFA-2 scores consistently demonstrated higher ICU mortality, confirming clinically meaningful reclassification. These findings provide additional external validation supporting the advantages of SOFA-2 for risk stratification in critically ill patients.

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Cite This Study

Bai et al. (Tue,) conducted a cohort in Critically ill patients (n=65,366). SOFA-2 vs. SOFA-1 was evaluated on ICU mortality (AUROC) (95% CI 0.823-0.835). SOFA-2 demonstrated superior discrimination for ICU mortality compared with SOFA-1 (AUROC 0.829 vs 0.796) in critically ill patients.

synapsesocial.com/papers/69c4cc98fdc3bde448917f8a https://doi.org/https://doi.org/10.1186/s40560-026-00875-6

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