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Discriminant Accuracy of the SOFA Score for Determining the Probable Mortality of Patients With COVID-19 Pneumonia Requiring Mechanical Ventilation

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The COVID-19 pandemic has raised concern regarding the capacity to provide care for a surge of critically ill patients that might require excluding patients with a low probability of short-term survival from receiving mechanical ventilation.1 A survey identified 26 unique COVID-19 triage policies, of which 20 used some form of the Sequential Organ Failure Assessment (SOFA) score.2

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Article Information

Accepted for Publication: February 1, 2021.

Published Online: February 17, 2021. doi:10.1001/jama.2021.1545

Corresponding Author: Robert A. Raschke, MD, 475 N Fifth St, Phoenix, AZ 85004 (raschkebob@gmail.com).

Author Contributions: Dr Raschke had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Raschke, Rangan, Heise, Curry.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Raschke, Rangan, Heise.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Raschke, Agarwal, Rangan, Heise.

Administrative, technical, or material support: Agarwal, Heise, Curry.

Supervision: Heise.

Conflict of Interest Disclosures: None reported.

Funding/Support: Funded in part by grant 2196 from the Flinn Foundation.

Role of the Funder/Sponsor: The Flinn Foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Truog  RD , Mitchell  C , Daley  GQ .  The toughest triage—allocating ventilators in a pandemic.   N Engl J Med. 2020;382(21):1973-1975. doi:10.1056/NEJMp2005689PubMedGoogle ScholarCrossref
2.
Antommaria  AHM , Gibb  TS , McGuire  AL ,  et al.  Ventilator triage policies during the COVID-19 pandemic at US hospitals associated with members of the Association of Bioethics Program Directors.   Ann Intern Med. 2020;173(3):188-194. doi:10.7326/M20-1738PubMedGoogle ScholarCrossref
3.
Seymour  CW , Liu  VX , Iwashyna  TJ ,  et al.  Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).   JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288 PubMedGoogle ScholarCrossref
4.
Raith  EP , Udy  AA , Bailey  M ,  et al.  Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit.   JAMA. 2017;317(3):290-300. doi:10.1001/jama.2016.20328 PubMedGoogle ScholarCrossref
5.
Gupta  S , Hayek  SS , Wang  W ,  et al; STOP-COVID Investigators.  Factors associated with death in critically ill patients with coronavirus disease 2019 in the US.   JAMA Intern Med. 2020;180:1436-1446. doi:10.1001/jamainternmed.2020.3596PubMedGoogle ScholarCrossref
6.
Kovach  CP , Fletcher  GS , Rudd  KE , Grant  RM , Carlbom  DJ .  Comparative prognostic accuracy of sepsis scores for hospital mortality in adults with suspected infection in non-ICU and ICU at an academic public hospital.   PLoS One. 2019;14(9):e0222563. doi:10.1371/journal.pone.0222563PubMedGoogle Scholar
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