Early Mortality Stratification with Serum Albumin and the Sequential Organ Failure Assessment Score at Emergency Department Admission in Septic Shock Patients
Sang-Min Kim,
Seung-Mok Ryoo,
Tae-Gun Shin,
You-Hwan Jo,
Kyuseok Kim,
Tae-Ho Lim,
Sung-Phil Chung,
Sung-Hyuk Choi,
Gil-Joon Suh,
Won-Young Kim
Affiliations
Sang-Min Kim
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Republic of Korea
Seung-Mok Ryoo
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Republic of Korea
Tae-Gun Shin
Department of Emergency Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
You-Hwan Jo
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
Kyuseok Kim
Department of Emergency Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13497, Republic of Korea
Tae-Ho Lim
Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul 15495, Republic of Korea
Sung-Phil Chung
Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
Sung-Hyuk Choi
Department of Emergency Medicine, College of Medicine, Korea University, Guro Hospital, Seoul 08308, Republic of Korea
Gil-Joon Suh
Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
Won-Young Kim
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Republic of Korea
Background: Early risk stratification is crucial due to septic patients’ heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined with serum albumin levels for predicting 28-day mortality in patients with septic shock. Methods: We conducted an observational study using a prospective, multicenter registry of septic shock patients between October 2015 and May 2022 from 12 emergency departments in the Korean Shock Society and the results were validated by examining those from the septic shock cohort in Asan Medical Center. The primary outcome was 28-day mortality. The area under the receiver operating characteristic (ROC) curve was used to compare the predictive values of SOFA score alone and SOFA score combined with serum albumin level. Results: Among 5805 septic shock patients, 1529 (26.3%) died within 28 days. Mortality increased stepwise with decreasing serum albumin levels (13.6% in albumin ≥3.5, 20.7% in 3.5–3.0, 29.7% in 3.0–2.5, 44.0% in 2.5–2.0, 56.4% in Conclusions: The combination of the initial SOFA score with albumin can improve prognostic accuracy for patients with septic shock, suggesting the albumin SOFA score may be used as an early mortality stratification tool.
