It is time for a SOFA-T score ?

Introduction:SOFA score predicts prognosis and in-hospital mortalityin septic patients, with a known AUC of 0.90. Troponin I (TnI) is amarker of myocardial injury and can be related to MOF and septic car-diomyopathy. We evaluated if adding TnI to SOFA score resulted in abetter prognostic performance in sepsis.Methods:49 septic patients were enrolled and prospectively followed-up. Outcome was in-hospital mortality, coded as binary. All the chroniccomorbidities and TnI were synthesized in different binary variables.SOFA score was coded as an ordinal variable: PaO2, FiO2, plateletcount, GCS, bilirubin, blood pressure and serum creatinine were thesingle items of the scale. SOFA-T was calculated adding 1 point to SSif TnI level was >0.05ng/ml. ROC curve analysis was performed withSPSS 13.0 for Windows.Results:Mean age was 75,83years(±13,14 years), males were54,8%. 35,7% of the patients died during the hospitalization. Of thesample, 45,4% were affected by diabetes, 73,7% by chronic cardio-vascular disease, 36,8% by cancer, 21,1% by hepatic disease, 52,6%by CKD, 36,8% by COPD, 26,3% by chronic neurologic disorders,15,8% by chronic haematologic pathologies, 31,6% by chronic gas-troenterologic disorders. SOFA had an AUC of 0.904(95%CI:0.718-1.089) in predicting in-hospital mortality. SOFA-T had an AUC of0.923(95%CI:0.768-1.078) for the same outcome. The difference be-tween the two ROC curves was statistically significant(p<0.05).Discussion:TnI increase could be associated to a worse prognosis insepsis. When included in SOFA, it enhances the AUC and the predictive value of this index.