{
  "abstract": "PURPOSE: The sequential organ failure assessment (SOFA) score was recently updated to better reflect contemporary intensive care. This study compares the predictive validity of the updated SOFA-2 and the previous SOFA-1 for 30-day mortality over the first week in ICU, overall and in subgroups with distinct age and comorbidity profiles. METHODS: We conducted a retrospective observational study of adult patients admitted to four ICUs in Sweden from 2010 to 2021. Predictive validity for 30-day mortality was assessed on day 1-7 using the area under the receiver operating characteristic curve (AUROC). RESULTS: We included 29,820 admissions (mean age 60 years, 64.8% males, median Charlson comorbidity index [CCI] 1). Reclassification between SOFA-1 and SOFA-2 occurred in 75-79% of admissions across days 1-7. On day 1, the AUROC for 30-day mortality was 0.81 (95% CI 0.80-0.81) for SOFA-2 and 0.80 (95% CI 0.79-0.81) for SOFA-1 (p < 0.001). From day 2 onward, AUROCs declined for both scores and were largely similar. Among trauma patients (mean age 50 years; median CCI 0), day-1 AUROC for SOFA-2 was 0.81 (95% CI 0.79-0.83), while among sepsis patients (mean age 61 years; median CCI 3) it was 0.72 (95% CI 0.70-0.74), with comparable performance for SOFA-1. CONCLUSIONS: SOFA-2 provided modestly better discrimination for 30-day mortality on ICU-day 1 compared with SOFA-1. Predictive validity diminished over subsequent days for both scores and varied across subgroups with different age and comorbidity distributions, underscoring the context-dependence of organ dysfunction scoring. TRIAL REGISTRATION: https://doi.org/10.5281/zenodo.17651826 , registration date November 19, 2025.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden",
    "Section of Anaesthesiology and Intensive Care Medicine, Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden",
    "Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden. anna.sundelin@ki.se",
    "Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care Karolinska Institutet, Karolinska Institutet, 171 77, Stockholm, Sweden. anna.sundelin@ki.se",
    "Department of Physiology and Pharmacology, Section of Anaesthesia and Intensive Care Karolinska Institutet, Karolinska Institutet, 171 77, Stockholm, Sweden"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Johan Helleberg"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Anna Sundelin",
      "orcid": "0009-0007-2508-5599"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Navid Soltani",
      "orcid": "0009-0008-6635-5804"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Olav Rooyackers",
      "orcid": "0000-0002-3391-5448"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Johan Mårtensson",
      "orcid": "0000-0001-8739-7896"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7r40hf894t3rk.bib",
  "cited_by": 8,
  "doi": "10.1186/s13054-026-06093-8",
  "fulltext_url": null,
  "id": "7r40hf894t3rk",
  "issns": [
    "1364-8535",
    "1466-609X",
    "1574-4280",
    "1875-7081"
  ],
  "landing_url": "https://doi.org/10.1186/s13054-026-06093-8",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7163006490",
  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s13054-026-06093-8.pdf",
  "pmcid": "PMC13224550",
  "pmid": "42226253",
  "published": "2026-06-01",
  "publisher": "BioMed Central",
  "ris": "https://research.draconitic.com/paper/7r40hf894t3rk.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T13:20:46Z",
      "native_id": "W7163006490",
      "source": "openalex",
      "url": "https://doi.org/10.1186/s13054-026-06093-8"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality",
  "title_text": "Predictive validity of daily sequential organ failure assessment (SOFA)-2 score for 30-day mortality",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T13:20:37Z",
  "url": "https://research.draconitic.com/paper/7r40hf894t3rk",
  "venue": "Critical Care",
  "versions": []
}