SOFA-T score is associated with an increased mortality rateamong patients affected by severe sepsis and septic shock

Background: Sepsis and septic shock(SS) are frequently managedin internal medicine departments(IMD). SOFA score is used to predictprognosis. Troponin I (TnI) has been associated to worse outcomes inseveral infections.Materials and Methods: All subjects admitted to our IMD for SS wereenrolled. Age, sex, lenght of admission, in-hospital mortality,SOFAscore, Troponin I(TnI), procalcitonin(PCT), C-reactive protein(CRP) andcomorbidities(diabetes, cardiovascula r(CV) pathologies,activecancer,chronic kidney disease(CKD), peripheral artery disease (PAD)and chronic obstructive lung disease (COPD)) were collected.SOFA-Twas obtained adding 1 point to SOFA if TnI was>0,05ng/ml. Coxregression analysis was performed using in-hospital mortality as mainoutcome and clinical characteristics as covariates. SOFA and SOFA-Twere used as predictors. Statistic was performed with SPSS.Results: 123 consecutive patients were enrolled, with mean age77,92 (±11,57) years, mean admission 15,23 (±9,62) days, meanTnI 1,64 (±0,483) ng/ml, mean PCT 11,65(±11,57)pg/ml and meanCRP 14,34 (±9,96) mg/dl. In-hospital mortality was 28,7%. Diabeteswas present in 38,0%, CV pathologies in 74,0%, active cancer in37,4%, COPD in 35,8%, CKD in 54,5% and PAD in 11,4% of thesample.Cox regression showed a significantly increased mortality rate(1,215; 95% CI: 1,077-1,371; p=0,002) for SOFA, which was higher(1,333; 95%CI: 1,121-1,585; p=0,001) for SOFA-T.Conclusions:The difference between the two mortality rates showedthat SOFA-T detected an increased 11,4% in the risk of death for SSevery 1-point increase in the score, if compared to SOFA score.