ArticleClinical medicine (London, England)2026
Comparative prognostic performance of SOFA-1 and SOFA-2 in patients with sepsis at ICU admission.
Article in Clinical medicine (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Cardiovascular disease: everybody's business.Clinical medicine (London, England) · 2026Article
- Prognostic discrimination of SOFA-2 vs. SOFA-1 and incremental information from cardiovascular scoring and vasoactive support intensity in patients with sepsis receiving early vasoactive therapy.Frontiers in cardiovascular medicine · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectiveSOFA-1 underpins Sepsis-3 definitions but may no longer optimally reflect contemporary ICU practice; SOFA-2 was recently developed from large multinational datasets, yet its prognostic performance in septic populations remains unknown. We aimed to compare the prognostic performance of SOFA-1 and SOFA-2 in ICU patients with sepsis.
designRetrospective cohort study. SETTING AND
participantsThis study was conducted using the MIMIC-IV database. A total of 30,667 adult patients (≥18 years) with first ICU admissions meeting Sepsis-3 criteria were included.
main outcome measuresICU mortality and in-hospital mortality. We compared discrimination (AUC), calibration, net reclassification improvement (NRI), integrated discrimination improvement (IDI), decision curve analysis and time-dependent survival.
resultsAmong 30,667 patients, 87.0% met both SOFA-1 and SOFA-2 criteria, 12.0% met only SOFA-2 criteria, and 1.0% met only SOFA-1 criteria. SOFA-2 total scores were systematically higher than SOFA-1, driven primarily by updated renal, cardiovascular and brain scoring criteria. SOFA-2 demonstrated modestly but consistently better discrimination for ICU mortality (AUC 0.779 vs. 0.755; P < 0.001) and hospital mortality (AUC 0.745 vs. 0.725; P < 0.001), with significant reclassification improvement for ICU mortality (NRI 0.143; IDI 0.020). In multivariable Cox models, SOFA-2 achieved higher AUCs for 7-day (0.790 vs. 0.771), 28-day (0.709 vs. 0.697) and 90-day mortality (0.682 vs. 0.671; all P < 0.001), with consistent advantages across all prespecified subgroups.
conclusionsSOFA-2 provides modestly but consistently better prognostic performance than SOFA-1 in septic ICU patients. Whether this incremental gain justifies the added scoring complexity warrants prospective evaluation.
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