Multiple organ failure after trauma affects even long-term survival and functional status

The multiple organ dysfunction (MOD) score and sequential organ failure assessment (SOFA) score are measures of organ dysfunction and have been validated based on the association of these scores with mortality. We sought to compare the performance of the SOFA and MOD scores in a large cohort of consecutive multisystem intensive care unit (ICU) patients.Prospective automated daily measurements of MOD and SOFA scores were performed in 1,436 patients admitted to a multisystem ICU in the Calgary Health Region over a one-year period. Logistic regression modeling techniques were used to describe the association of SOFA and MODS with mortality. Receiver operator characteristic (ROC) curves were used to assess the model's discriminatory ability.For ICU and hospital mortality, there was very little practical difference between the SOFA and MOD scores in their ability to discriminate outcome as determined by the area under the ROC. However, compared to previous literature, the discriminatory ability of both scores in this population was weak. As well, the calibration of the models was poor for both scores. The SOFA cardiovascular component score performed better than the MOD cardiovascular component score in the discrimination of both ICU and hospital mortality.SOFA and MOD scores had only a modest ability to discriminate between survivors and non-survivors. These results question the appropriateness of using organ dysfunction scores as a 'surrogate' for mortality in clinical trials and suggest further work is necessary to better understand the temporal relationship and course of organ failure with mortality.

Objective To study the predictive value of acute gastrointestinal injury (AGI) grading system introduced into Sequential Organ Failure Assessment (SOFA) score in patients with severe acute pancreatitis (SAP) in order to provide a reliable clinical tool for the evaluation of prognosis of SAP. Methods Patients with acute pancreatitis admitted to ICU from July 2012 to July 2014 were enrolled for study. The criteria of exclusion were the age below 18 years old, pregnancy, or patients without consent to the treatment. A total of 63 patients with 37 males and 26 females aged (47 ±15.3) years were included. The data of their acute physiology and chronic health evaluation (APACHE) Ⅱ score, the highest SOFA score and AGI grade within the first week, and the 28-day mortality rate were collected. Patients without AGI were defined as zero point, and AGI grade I -IV were defined as 1-4 points. The receiver operating characteristic curve (ROC) was used to evaluate the value of APACHEⅡ score, SOFA score, and SOFA + AGI score in predicting the prognosis of SAP. The areas under ROC curve (AUC) of the APACHEⅡ score, SOFA score, and SOFA +AGI score were compared with MedCalc software, and P value less than 0.01 was considered to be statistical significance. Results (1) The 28-day mortality of the 63 patients with SAP was 20.6% (13/63), in which 50 patients in the survival group, 13 patients in the death group. The APACHEⅡ scores of two groups were (15.62 ± 4.33 vs. 12.10 ± 3.74, P =0.0048), the SOFA scores were (14.77 ± 3.09 vs. 9.24 ± 2.88, P <0.01), and the SOFA +AGI scores were (18.77 ± 3.09 vs. 10.74 ± 3.17, P <0.01). (2) The AUC of APACHEⅡ score was 0.748 ± 0.084 (95% CI: 0.622-0.849), the AUC of SOFA score was 0.902 ± 0.059 (95% CI: 0.801-0.962), and the AUC of SOFA +AGI score was 0.963 ± 0.037 (95% CI, 0.882-0.994) ; There was no significant difference in AUC between APACHEⅡ score and SOFA score (P =0.10) , and there was statistical significance between the AUC of APACHEⅡ score and that of SOFA +AGI score (P =0.013) , and the difference in AUC between SOFA score and SOFA +AGI score was statistically significant (P =0.008). The Youden index and the positive likelihood ratio of SOFA +AGI score system were the greatest to be 0.863 and 15.38, respectively. Conclusions SOFA scoring system has better predictive value in patients with SAP when AGI grading system was introduced into it. Key words: Acute gastrointestinal injury grading system; APACHEⅡ score; SOFA score; Severe acute pancreatitis; Prognosis

The novel coronavirus disease, COVID-19, is caused by a SARS-COV-2 infection and manifested in some clinical forms from mild to critical disease. The Sequential Organ Failure Assessment (SOFA) score has been used to predict the clinical outcomes of patients admitted to intensive care units with multiple organ failures. This study aimed to analyse the cut-off of the SOFA score with the best accuracy in predicting mortality in severe and critical COVID-19 population, and compared the survival rate difference of the high and low SOFA score according to the cut-off with the best accuracy from our study. This retrospective observational study analysed all of the severe and critical COVID-19 patients admitted to DR.Soetomo Hospital, Surabaya, Indonesia, from June to September 2020. We excluded patients who had died less than 48 hours upon ICU admission and patients who were discharged against medical advice (DAMA). A total of 123 patients were eligible. SOFA score significantly predicted ICU mortality of COVID-19 patients with the Area-under-curve of 0.9 (p<0.001). The survival rate of patients with the SOFA score of ?7 was 90%, compared to patients with the SOFA score of >7 with a survival rate of 10%. Patients with SOFA score ? 7 had a significantly longer survival time during ICU care (HR=15.85, p<0.001). Our study proved that patients with higher SOFA scores had a significantly different survival outcome during the ICU stay, with the score cut-off of 7. This score cut-off could significantly discriminate ICU survival with high predictive values.

Objective To evaluate the application value of maximum sequential organ failure assessment (SOFA) score and mean SOFA score for the prediction of clinical outcome in patients with sepsis caused by gram-positive/gram-major pathogens. Methods Patients diagnosed sepsis of emergency ICU and comprehensive ICU of our hospital, from Oct. 2016 to Jul. 2017 were included in our study. Blood culture and sputum culture were immediately taken at the time of admission, and the pathogenic bacteria were isolated. All patients were divided into Gram-negative bacteria (G-) group and Gram-positive bacteria (G+) group and G-pathogenic bacteria (G+) group according to the pathogen test results. PO2/FiO2 (represented respiratory system function), total bilirubin (represented liver function), creatinine (represented kidney function), mean arterial pressure (represented circulation system function), platelet count (represented coagulation function), and GCS score (represented brain function) were collected at the time of admission, 24 hours, 48 hours, 72 hours, 4 days, 5 days... after admission, until the patient died or out of hospital. Then, calculated maximum SOFA score and mean SOFA score. Results Totally 62 patients were enrolled, including 20 females and 42 males, with an average age of (65.79±14.17) years. There were 28 cases in the G+ group and 34 cases in the G- group. The maximum SOFA score showed a clear correlation with the number of patient′s organ failure (G+ male, correlation coefficient 0.927; G+ female, correlation coefficient 0.847, P<0.05; G- male, correlation coefficient 0.719, P<0.01); the maximum SOFA score was significantly associated with the prognosis of death of patients (G+ correlation coefficient 0.480, G- correlation coefficient 0.621, P<0.01); the maximum SOFA score showed the highest area under the ROC curve. Conclusions Maximum SOFA score was associated with the number of patient′s organ failure and the death outcome of patient. Maximum SOFA score also showed more significance value in evaluating prognosis. Key words: SOFA core; Gram-positive pathogen; Gram-negative pathogen; Clinical outcome

Introduction: Forecasting mortality among trauma patients in the intensive care unit (ICU) is crucial for advancing treatment approaches and elevating the standard of patient care. Objectives: The purpose of this research was to compare well-known severity-of-disease scores in predicting the mortality of trauma patients in the ICU. Materials and Methods: This cross-sectional study was conducted from 2016 to 2017 at the ICU of Amin Hospital, which is affiliated with a university in Isfahan, Iran. Information for calculating the Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) score, Injury Severity Score (ISS), and M Score was extracted from patients’ files and compared with their mortality using receiver operating characteristic (ROC) curves. Results: Our study showed that the M Score and SOFA Score have sensitivities of 94.5 and 88.29, and specificities of 88.9 and 80.14, respectively. When comparing the AUC of mean SOFA, mean M Score, APACHE II, and ISS across different age groups and the entire study population, we found that the M Score and SOFA significantly better predict mortality than APACHE II and ISS. Conclusion: This study showed that the M Score and SOFA Score predict the mortality of trauma patients admitted to the ICU better than APACHE II, and that ISS is not appropriate for this task.

Introduction: Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) has been reported to improve survival in patients with cardiogenic shock or cardiac arrest. However, the prognostic predictors were uncertain. We investigated the association between sequential organ failure assessment (SOFA) score just before implantation and clinical outcome in patients undergoing VA-ECMO due to cardiogenic shock and cardiac arrest. Methods: A cohort of 299 patients who underwent ECMO at our hospital was registered from January 2005 to April 2015. We excluded 72 patients caused by non-cardiogenic event. The remaining 227 patients (58±14 years old, male82%) were divided into 2 groups according to initial sequential organ failure assessment (SOFA) score . High SOFA Group: SOFA score ≥13 points (n=106); Low SOFA Group: SOFA score &lt;13 (n=121). Clinical outcome was all -cause death at 30 days. Results: The 87% of patients received VA-ECMO due to cardiac arrest(81 out-of-hospital cardiac arrest, 116 in-hospital cardiac arrest). In baseline characteristics, Low SOFA group was significantly shorter time from collapse to ECMO (35.1 vs. 40.7 min), higher Hb (13.1 vs. 11.6 g/dl), and lower BUN (18.1 vs. 24.4 mEq/l, all p&lt;0.05) than High SOFA group. Incidence of death at 30days was significantly lower in Low SOFA group than in High SOFA group (Low SOFA vs. High SOFA; 56.2% vs. 76.4%: p= 0.0014) . Kaplan-Meier curve showed Low SOFA group was better outcome compared with High group (p&lt;0.001, log-rank test) (Figure). SOFA score was an independent predictor of mortality after adjustment of multiple cofounders (SOFA Score per increase, OR: 1.18, 95% confidence interval: 1.00-1.39, p=0.047). Positive independent predictors of mortality were age (per increase OR: 1.04, 95% CI: 1.01-1.07, p&lt;0.01) and other factors. Conclusions: Initial high SOFA score just before implantation provides worse clinical outcome in patients with VA-ECMO due to cardiogenic shock and cardiac arrest.

Purpose:The purpose of this study is to examine the prevalence, clinical spectrum, prognostic factors, and outcome of multi-organ dysfunction syndrome (MODS) in patients with malaria.Materials and Methods:One hundred and twenty-four patients with malaria, diagnosed by a positive peripheral blood film and rapid malaria test, were studied for MODS using the sequential organ failure assessment (SOFA) score. The severity of malaria was assessed by the WHO criteria.Results:Severe malaria was present in 54 (43.54%) patients. MODS was detected in 108 (87.09%) patients with malaria (Plasmodium falciparum - 57 [85.07%], Plasmodium vivax - 46 [88.46%] and mixed P. falciparum and P. vivax malaria - 5 [100%] cases). SOFA scores of MODS-and non-MODS-patients differed significantly (P < 0.001). No significant association was seen between MODS and type of malaria (P = 0.894). Mortality among malaria patients with MODS was 5.55% (6/108) (P. falciparum 8.77% [5/57] and P. vivax 2.17% [1/46]). The outcome of MODS was associated significantly with the severity of the SOFA score at admission (P = 0.011) but not with the type of malaria, malaria parasite index, and the number of organs involved (P > 0.05 each). The SOFA score at admission correlated significantly with the duration of hospitalization (P < 0.0001).Conclusions:MODS occurs with high frequency in malaria and is not dependent on the type of malaria. The outcome of MODS and recovery time depends on the severity of MODS. The SOFA score is useful in detecting MODS and ascertaining its severity and prognosis in malaria.

The main objective in this study was to assess the relative importance of chronic and acute organ failures in mortality prediction in patients with suspected sepsis at hospital admission. We also evaluated how the presence of infection influenced the ability of SOFA to predict 30-day mortality. Single-center prospective cohort study including 1,313 adult patients with suspected sepsis in rapid response teams in the emergency department. The main outcome was 30-day mortality. We measured the maximum total SOFA score during admission (SOFATotal), whereas preexisting chronic organ failure SOFA (SOFAChronic) score was assessed by chart review, allowing calculation of the corresponding acute SOFA (SOFAAcute) score. Likelihood of infection was determined post hoc as "No infection" or "Infection." SOFAAcute and SOFAChronic were both associated with 30-day mortality, adjusted for age and sex (adjusted odds ratios [AORs], 1.3; 95% CI, 1.3-14 and 1.3; 1.2-1.7), respectively. Presence of infection was associated with lower 30-day mortality (AOR, 0.4; 95% CI, 0.2-0.6), even when corrected for SOFA. In "No infection" patients, SOFAAcute was not associated with mortality (AOR, 1.1; 95% CI, 1.0-1.2), and in this subgroup, neither SOFAAcute greater than or equal to 2 (relative risk [RR], 1.1; 95% CI, 0.6-1.8) nor SOFATotal greater than or equal to 2 (RR, 3.6; 95% CI, 0.9-14.1) was associated with higher mortality. Chronic and acute organ failures were equally associated with 30-day mortality in suspected sepsis. A substantial part of the total SOFA score was due to chronic organ failure, calling for caution when using total SOFA in defining sepsis and as an outcome in intervention studies. SOFA's mortality prediction ability was highly dependent on actual presence of infection.

BackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is a diagnostic marker for acute kidney injury (AKI). NGAL expression is highly induced not only in kidney injury but also in bacterial infection, inflammation, and cancer. The factors regulating NGAL expression are proinflammatory cytokines, and plasma NGAL levels have been increased in septic shock. However, there are no reports of urine neutrophil gelatinase-associated lipocalin (uNGAL) levels after open esophagectomy.MethodsWe prospectively enrolled critically ill patients, including patients with sepsis (n = 45) and patients who underwent open esophagectomy (n = 40). We compared vital signs, PaO2/FIO2, serum C-reactive protein (CRP) levels, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, and uNGAL levels between the sepsis group and the esophagectomy group. Then, we investigated whether uNGAL is associated with the severity of illness and organ failure, and whether uNGAL is a reliable screening test for AKI.ResultsThe median uNGAL levels, APACHE II score, SOFA score, and serum CRP levels were significantly (p < 0.001) higher in the sepsis group than in the esophagectomy group on ICU day 1. In the sepsis group, uNGAL levels were significantly (p < 0.05) correlated with APACHE II score and SOFA score on intensive care unit (ICU) day 1, 2, and 3. In the esophagectomy group, uNGAL levels were significantly (p < 0.05) correlated with SOFA score on ICU day 3 and 4. In the sepsis group, 1 patient developed AKI stage 2 and 6 patients developed AKI stage 3. No patients developed AKI in the esophagectomy group. In a total of 85 patients of this study, 80 patients had an abnormal value of uNGAL and only 7 patients (8.7%) of those 80 patients developed AKI.ConclusionsuNGAL levels were correlated with the severity of illness and organ failure in critically ill patients. The value of uNGAL increases under the surgical and inflammatory responses, thereby losing a significance of a screening test of AKI in critically ill patients.

BACKGROUNDSystemic immune-mediated diseases can be quite severe in both course and complications, causing multiple organ failure and death. These patients are often required to be hospitalized in an intensive care unit (ICU).AIMTo find early predictors of death in patients with immune-inflammatory diseases hospitalized in the ICU.METHODSThe study included 51 patients (23 boys, 28 girls) with immune-inflammatory diseases, including multisystem inflammatory syndrome associated with coronavirus disease 2019 (n = 18), systemic rheumatic diseases (n = 24), and generalized infections (n = 9) aged from 7 months up to 17 years old, admitted to the ICU of the clinic of Saint Petersburg State Pediatric Medical University in the period from 2007 to 2023. All patients were divided into those with a fatal outcome (n = 13) and those who recovered (n = 38). Macrophage activation syndrome (MAS) was diagnosed by the 2016 European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organisation criteria.RESULTSFirst-day predictors were white blood cell ≤ 3.1 × 109/L, platelets ≤ 168 × 109/L, diuresis ≤ 1.5 mL/kg/hour, low saturation, K+ > 4.7 mmol/L, albumin ≤ 30 g/L, creatinine > 74 μmol/L, pH ≤ 7.36, HCO3- ≤ 22.2, Glasgow Coma Scale score ≤ 13, Sequential Organ Failure Assessment (SOFA) score > 2, oxygen therapy, mechanical ventilation (MV), fresh frozen plasma transfusions and biological treatment. The third-day predictors were: White blood cell ≤ 4.0 × 109/L, platelets ≤ 63 × 109/L, hemoglobin ≤ 87 g/L, C-reactive protein (CRP) > 129 mg/L, triglycerides > 2.45 mmol/L, albumin ≤ 28 g/L, creatinine > 83.5 μmol/L, pH ≤ 7.38, Glasgow Coma Scale score ≤ 10, SOFA score > 2 and need in MV, intravenous immunoglobulin, and blood transfusion requirements. On the fifth day, the main predictors were CRP > 28 mg/L, triglycerides > 2.3 mmol/L, creatinine > 58 μmol/L, fibrinogen > 3.3 g/L, compliance with the MAS criteria, Glasgow Coma Scale score ≤ 14, SOFA score > 2, and need for MV, vasopressors, and anticoagulant therapy, as well as blood and fresh frozen plasma transfusions. The seventh-day predictors were CRP > 19.1 mg/L, albumin ≤ 35 g/L, total protein ≤ 55 g/L, compliance with the MAS criteria, Glasgow Coma Scale score ≤ 12, SOFA score > 3, and need for MV and biological and anticoagulant therapy.CONCLUSIONHemaphagocytosis (leukopenia, thrombocytopenia, hyperferritinemia, increased histochemistry score), progressive decline in Glasgow Coma Scale, increasing SOFA scores, and persistent high CRP levels were markers of an unfavorable outcome in patients with immune-mediated inflammatory diseases.

BackgroundSepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia.MethodsWe prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia (n = 3), Thailand (n = 3), and Vietnam (n = 3). In patients with organ dysfunction (total SOFA score ≥ 2), we analyzed sepsis management and outcomes and evaluated mortality prediction of the SOFA scores. Organ failure was defined as the maximum SOFA score ≥ 3 for an individual organ system.ResultsFrom December 2013 to December 2015, 454 adult patients presenting with community-acquired sepsis due to diverse etiologies were enrolled. Compliance with sepsis bundles within 24 h of admission was low: broad-spectrum antibiotics in 76% (344/454), ≥ 1500 mL fluid in 50% of patients with hypotension or lactate ≥ 4 mmol/L (115/231), and adrenergic agents in 71% of patients with hypotension (135/191). Three hundred and fifty-five patients (78%) were managed outside of ICUs. Ninety-nine patients (22%) died. Total SOFA score on admission of those who subsequently died was significantly higher than that of those who survived (6.7 vs. 4.6, p < 0.001). The number of organ failures showed a significant correlation with 28-day mortality, which ranged from 7% in patients without any organ failure to 47% in those with failure of at least four organs (p < 0.001). The area under the receiver operating characteristic curve of the total SOFA score for discrimination of mortality was 0.68 (95% CI 0.62–0.74).ConclusionsCommunity-acquired sepsis in Southeast Asia due to a variety of pathogens is usually managed outside the ICU and with poor compliance to sepsis bundles. In this population, calculation of SOFA scores is feasible and SOFA scores are associated with mortality.Trial registrationClinicalTrials.gov, NCT02157259. Registered 5 June 2014, retrospectively registered.

BackgroundThere is a need to update the cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score to reflect the current practice in sepsis. We previously proposed the modified CV SOFA score from data on blood pressure, norepinephrine equivalent dose, and lactate as gathered from emergency departments. In this study, we externally validated the modified CV SOFA score in multicenter intensive care unit (ICU) patients.MethodsA multicenter retrospective observational study was conducted on ICU patients at six hospitals in Korea. We included adult patients with sepsis who were admitted to ICUs. We compared the prognostic performance of the modified CV/total SOFA score and the original CV/total SOFA score in predicting 28-day mortality. Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and the calibration curve, respectively.ResultsWe analyzed 1,015 ICU patients with sepsis. In overall patients, the 28-day mortality rate was 31.2%. The predictive validity of the modified CV SOFA (AUROC, 0.712; 95% confidence interval [CI], 0.677–0.746; P < 0.001) was significantly higher than that of the original CV SOFA (AUROC, 0.644; 95% CI, 0.611–0.677). The predictive validity of modified total SOFA score for 28-day mortality was significantly higher than that of the original total SOFA (AUROC, 0.747 vs. 0.730; 95% CI, 0.715–0.779; P = 0.002). The calibration curve of the original CV SOFA for 28-day mortality showed poor calibration. In contrast, the calibration curve of the modified CV SOFA for 28-day mortality showed good calibration.ConclusionIn patients with sepsis in the ICU, the modified SOFA score performed better than the original SOFA score in predicting 28-day mortality.

Acute severe pancreatitis caused high mortality, and several scoring systems for predicting mortality are available. We evaluated the effectiveness of serial measurement of several scoring systems in patients with acute severe pancreatitis.We retrospectively obtained serial measurements of Ranson, Acute Physiology and Chronic Health Assessment (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scores of 159 patients with acute severe pancreatitis.The overall mortality rate was 20%, and early mortality (in the first 2 weeks) occurred in 10 (7.4%) patients, while late mortality occurred in 17 (12.6%).All scoring systems were reliable for predicting overall and intensive care unit mortality, while the SOFA score on day 7 presented the largest area under the receiver operator characteristic (ROC) curve (0.858, SE 0.055). Changes in scores over time were evaluated for predicting the progression of organ failure, and the change in SOFA score on hospital day 7 or no interval change in SOFA score was associated with higher mortality rates.APACHE II and SOFA scores are both sensitive for predicting mortality in acute pancreatitis. The serial SOFA scores showed reliable for predicting mortality. Hospital day 7 is a reasonable time for SOFA score reassessment to predict late mortality in acute severe pancreatitis.

To summarize the experiences of percutaneous cardiopulmonary support system (PCPS) for critically ill patients and examine the risk factors associated with prognosis. The clinical data of 22 patients with acute severe cardiorespiratory failure on PCPS at intensive care unit of Zhejiang Provincial People's Hospital from September 2006 to February 2013 were retrospectively collected and analyzed. According to the prognosis, they were divided into the survival and mortality groups. And their risk factors of prognosis were analyzed. The PCPS support time was 2-334 (75 ± 10) hours, 14 cases (63.6%) were successfully weaned and 12 cases (54.6%) discharged. The inter-group differences of blood lactic acid level before PCPS, heart ejection fraction, sequential organ failure assessment (SOFA) score and number of multiple organ failure (> 3) were statistically significant (P < 0.05). PCPS is an effective approach for severe acute patients with cardiopulmonary failure. And blood lactic acid level before PCPS, heart ejection fraction, SOFA score and number of multiple organ failure (>3) may be the risk factors related with prognosis.

The use of the Sequential Organ Failure Assessment (SOFA) score, originally developed to describe disease morbidity, is commonly used to predict in-hospital mortality. During the COVID-19 pandemic, many protocols for crisis standards of care used the SOFA score to select patients to be deprioritized due to a low likelihood of survival. A prior study found that age outperformed the SOFA score for mortality prediction in patients with COVID-19, but was limited to a small cohort of intensive care unit (ICU) patients and did not address whether their findings were unique to patients with COVID-19. Moreover, it is not known how well these measures perform across races. In this retrospective study, we compare the performance of age and SOFA score in predicting in-hospital mortality across two cohorts: a cohort of 2,648 consecutive adult patients diagnosed with COVID-19 who were admitted to a large academic health system in the northeastern United States over a 4-month period in 2020 and a cohort of 75,601 patients admitted to one of 335 ICUs in the eICU database between 2014 and 2015. We used age and the maximum SOFA score as predictor variables in separate univariate logistic regression models for in-hospital mortality and calculated area under the receiver operator characteristic curves (AU-ROCs) and area under precision-recall curves (AU-PRCs) for each predictor in both cohorts. Among the COVID-19 cohort, age (AU-ROC 0.795, 95% CI 0.762, 0.828) had a significantly better discrimination than SOFA score (AU-ROC 0.679, 95% CI 0.638, 0.721) for mortality prediction. Conversely, age (AU-ROC 0.628 95% CI 0.608, 0.628) underperformed compared to SOFA score (AU-ROC 0.735, 95% CI 0.726, 0.745) in non-COVID-19 ICU patients in the eICU database. There was no difference between Black and White COVID-19 patients in performance of either age or SOFA Score. Our findings bring into question the utility of SOFA score-based resource allocation in COVID-19 crisis standards of care.