A56-17 Correlation of Sequential Organ Failure Assessment (SOFA) Score and Serum Lactate in Streptococcal Bacteremia: A Demographic and Prognostic Analysis in a Minority and Low-Income Community in New York

Introduction Streptococcal bacteremia associated with pneumonia represents a critical cause of sepsis-related mortality worldwide. Early recognition of organ dysfunction is essential for guiding management and predicting outcomes. The Sequential Organ Failure Assessment (SOFA) score quantifies multi-organ dysfunction, while serum lactate reflects systemic hypoperfusion and metabolic distress. Although both parameters are widely used, their combined predictive power and interaction within specific subpopulations remain incompletely defined. This study aimed to characterize the demographic profile of patients with Streptococcal bacteremia in a minority low-income population and evaluate the relationships among SOFA score, lactic acid, and mortality. Findings were compared with the results of Iftikhar & Waagsbø (2025), who validated SOFA as a leading predictor of mortality in community-acquired pneumonia (CAP). Methods A retrospective study was conducted on 28 adults with confirmed Streptococcal bacteremia. Demographic variables included sex, age, ethnicity, HIV status, and intravenous drug use (IVDU). Descriptive statistics summarize population characteristics. Correlations between SOFA score and lactate were assessed using Pearson’s and Spearman’s coefficients. Multivariable regression examined predictors of SOFA and mortality, incorporating infection-related and demographic covariates. Results The cohort was 53.6% male, mean age 60.6 ± 13.1 years, and predominantly Black African American (60.7%). HIV positivity was present at 17.9%, and IVDU in 10.7%. Lactate correlated moderately and positively with SOFA (r = 0.39, p = 0.042), indicating that greater lactate elevation corresponded to more severe organ dysfunction. Patients who expired exhibited SOFA scores 4-7 points higher than survivors (β = +4.53, p = 0.02) and lactate concentrations approximately 6 mmol/L higher (β = +5.95, p < 0.001). Mortality status explained 56% of the variance in lactate values (R² = 0.56). Neither HIV nor IVDU independently predicted SOFA or mortality, likely to reflect limited sample power. Conclusions SOFA score and serum lactate represent complementary, independent predictors of mortality in Streptococcal bacteremia with pneumonia. Elevated SOFA reflects multi-organ dysfunction, whereas lactate signifies tissue hypoperfusion; their concurrent rise identifies patients at highest mortality risk. The strong SOFA-mortality correlation aligns with the findings of Iftikhar & Waagsbø (2025), who reported a SOFA AUROC = 0.95 for predicting death in CAP. Collectively, these data affirm SOFA’s generalizable validity and highlight the additive prognostic value of lactate. Early identification of patients with SOFA ≥ 4 or lactate > 4 mmol/L should trigger aggressive resuscitation and ICU evaluation to improve survival outcomes. This abstract is funded by: None