Abstract

To compare PIRO vs. SOFA scores in predicting mortality in septic patients admitted to ICU. Material and Methods: This prospective observational study was conducted in the department of Anesthesia and Critical Care at Sher-i-Kashmir Institute of Medical Sciences, Srinagar during 2018 to 2020 among 200 patients admitted in ICU having sepsis fulfilling inclusion criteria. The PIRO and SOFA scores were calculated from the individual data elements collected in the ICU and recorded on the charts. The most abnormal value recorded in the ICU was used in the score calculations, with the exception of Glasgow Coma Scale score for the SOFA score, which was the best presedation value recorded (as per convention). Blood pressure following IV crystalloid bolus was used for the PIRO score. All data were abstracted into structured proformas by a single investigator. Results: During the course of this study, a total of 95 patients out of the 200 patients in the study group died, majority had sepsis or septic shock and the overall mortality at 21 days was 47.5%. Among patients admitted to the ICU (n = 200), the PIRO score was superior to the SOFA score: AUC 0.58 versus 0.45. The mean score was high in PIRO group (15.34+/-4.114) as compared to SOFA score (10.52+/-3.560). It was also found that platelet counts <1.5 lakhs, creatinine levels >1.8mg/dl. GCS < 9, age group > 56 years, pneumonia, heart rate >120beats/min, lactate levels > 2mmol and systolic blood pressure < 90 mmHg on admission to ICU had an influence on the 21day mortality rates and the comparison was statistically significant with p-value <0.05. Conclusion: PIRO model, taking into account comorbidities and septic source as well as physiologic status, performed better than SOFA for predicting mortality in Surgical ICU patients with sepsis and septic shock

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