SOFA-2 reclassifies multiorgan dysfunction syndrome in major trauma patients

A study compared the performance of the updated SOFA-2 scoring scale with the original SOFA-1 in classifying organ dysfunction in 2162 severely injured patients. SOFA-2 reduced the proportion of patients classified with multiorgan dysfunction (MODS) from 68.5% to 61.6%. SOFA-2 scores on the first day after admission were lower than SOFA-1 (median 6 versus 7), driven by lower respiratory and cardiovascular scoring. A group of 159 patients (7.3%) classified as MODS by SOFA-1 were reclassified as no-MODS by SOFA-2; however, these patients had higher ICU mortality (7.5% versus 0.7%), greater ventilator and vasopressor requirements, and longer hospital stays. SOFA-2 represents an important update in MODS measurement in trauma patients with implications for future clinical trial design.