Objective
=========

To assess the ability of the SOFA score (Sequential Organ Failure Assessment) to discriminate outcome in neurological patients admitted to intensive care unit (ICU).

Setting
=======

A 24-bed general ICU in a 260-bed public hospital.

Methods
=======

We prospectively followed (from May to September 2001) neurological patients admitted to our ICU measuring daily SOFA score throughout the first 7-day ICU stay and recording the 28-day mortality. We compared median scores between survivors and non-survivors (Mann-Whitney U-test) and calculated risk relative of death. Admission APACHE II score was calculated for each patient.

Results
=======

We studied 45 patients (29 M/16 F). The mean age was 47.8 ± 13.2 years and mean APACHE II was 14.2 ± 5.1. The mean LOS was 12.8 ± 8.3 days. The 28-day ICU mortality was 31% (*n* = 14).The best cut-off value of SOFA score was 7. Clinical diagnosis at admission were: intracerebral haematoma (*n* = 14), extradural haematoma (*n* = 9), subarachnoid hemorrhage (*n* = 7), brain swelling (*n* = 5), subdural haematoma (*n* = 4), gun shot injury (*n* = 3), diffuse axonal lesion (*n* = 2), meningitis (*n* = 1).

Conclusions
===========

SOFA score can be used to discriminate outcome in neurological patients admitted in ICU.

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Comparison between median SOFA score in survivors and non-survivors

         Survivors   Non-survivors   P
  ------ ----------- --------------- --------
  SOFA                               
   D0    5 (4--6)    6 (6--7)        0.03
   D1    5 (3--6)    7 (6--8)        0.006
   D2    6 (3--7)    7 (6.5--8)      0.03
   D7    4 (3--5)    7.5 (7--9.5)    0.0001

###### 

Risk relative of death on days 0, 1, 2 and 7

               D0          D1          D2          D7
  ------------ ----------- ----------- ----------- ----------
  SOFA *f* 7                                       
   RR          2.3         2.6         6.0         14.3
   CI          1.03--5.2   1.13--6.2   1.5--24.5   1.9--105
