Comparative Evaluation of SOFA and SAPS-3 Scores for Predicting Intensive Care Unit Mortality in Sepsis Patients: A Prospective Observational Study from South India

Background: Sepsis is a life-threatening state resulting from an ineffective biological host response to infection resulting in organ dysfunction with high mortality, especially in intensive care unit (ICU) settings.Despite progress in its management, early prognosis of sepsis remains difficult.Severity scoring systems have been developed to assess disease severity and predict outcomes, including the sequential organ failure assessment (SOFA) score and the simplified acute physiology score-3 (SAPS-3).This study sought to evaluate and compare the prognostic utility of SOFA and SAPS-3 scores in predicting ICU mortality in patients with sepsis at a tertiary care center in South India. Materials and methods:A prospective observational study was performed on 316 adult patients who were admitted to the medical ICU with a confirmed or probable diagnosis of sepsis based on the criteria of sepsis-3 definition.Sequential organ failure assessment and SAPS-3 scores were determined using the relevant worst clinical and laboratory parameters recorded within the first 24 hours of ICU admission.Follow-up continued through discharge or death.Statistical analysis included Chi-square tests, binomial logistic regression for predictor variables, and receiver operating characteristic (ROC) curve to ascertain the predictive accuracy of each scoring system.Results: Of the 316 sepsis patients enrolled, ICU mortality was 56%, with non-survivors being significantly older and having higher rates of ventilation and inotrope use (p < 0.05).All severity scores were significantly elevated among non-survivors (p < 0.001).Receiver operating characteristic analysis demonstrated that SOFA [area under the curve (AUC) = 0.832] and SAPS-3 (AUC = 0.819) had excellent discriminative ability for predicting ICU mortality, outperforming Oxford acute severity of illness score (OASIS) (AUC = 0.779) and logistic organ dysfunction system (LODS) (AUC = 0.722).Thus, SOFA and SAPS-3 emerged as the most reliable prognostic tools for outcome prediction in sepsis patients in South Indian ICUs.Conclusion: The prognostic value of SOFA and SAPS-3 scores for predicting ICU mortality among patients with sepsis was excellent.Sequential organ failure assessment also had slightly more discriminative ability than SAPS-3, making it a useful and trusted tool for predicting outcomes early and guiding clinical decisions in critical care.