Work

Discriminatory power of organ-specific Sequential Organ Failure Assessment (SOFA) scores: Predictors of maternal mortality in obstetric intensive care units (ICU)

Year: 2026

Type: article

Abstract: Background: Critically ill obstetric patients in intensive care units (ICUs) present unique challenges, and maternal mortality remains a major concern, particularly in low- and middle-income countries. The Sequential Organ Failure Assessment (SOFA) score, though widely used in general ICUs, has not been adequately studied for its organ-specific discriminatory power in predicting maternal mortality. This study aimed to evaluate the prognostic accuracy of individual organ SOFA sub-scores to improve risk stratification in obstetric critical care. Methods: This prospective observational study was conducted over one year in the obstetric ICU of a tertiary center in Northern India. A total of 125 obstetric patients (pregnant or within 42 days postpartum) were enrolled. SOFA sub-scores for respiratory, cardiovascular, hepatic, renal, coagulation, and neurological systems were calculated on admission and throughout ICU stay. Patients were classified into survivors and non-survivors. Associations between individual organ dysfunction and maternal mortality were assessed. Discriminatory accuracy of organ-specific SOFA scores was determined using receiver operating characteristic (ROC) curve analysis. Results: < 0.001). Escalating organ-specific SOFA scores were significantly associated with maternal mortality. ROC analysis revealed that cardiovascular dysfunction had the highest predictive accuracy (area under the curve [AUC] =0.875), followed by hepatic (AUC = 0.808), respiratory (AUC = 0.804), hematological (AUC = 0.763), and renal (AUC = 0.757) dysfunction. Conclusion: Cardiovascular, hepatic, and respiratory SOFA sub-scores provide strong discriminatory power for predicting maternal mortality in Obstetric ICU patients. Incorporating organ-specific SOFA assessments may enhance early risk stratification and guide life-saving interventions in resource-limited settings.

Source: Journal of Family Medicine and Primary Care

DOI: 10.4103/jfmpc.jfmpc_2216_25

Authors: Monica Agrawal, Kathipri Nelia, Armin Ahmed, Sujata Deo, Shyam P. Jaiswar

Institution: King George's Medical University

Language: English

Topic: Sepsis Diagnosis and Treatment

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $450