Performance of sequential organ failure assessment 1 versus 2 for sepsis identification in patients with suspected infection: a multicenter retrospective cohort study
Authors' conclusion
SOFA-2-based sepsis identified a clinically meaningful higher-risk subgroup, with consistent results across sensitivity analyses.
Study context
- Population
- Patients with suspected infection, Chinese multicentre cohort, validated in the MIMIC-IV databaseChinese multicentre cohort
- Participants
- 24,510 patients
- Exposure
- Sequential Organ Failure Assessment (SOFA-2) vs SOFA-1 definition for sepsis identification
- SOFA-1(+)/SOFA-2(+)n = 18,179
- Outcome
- In-hospital mortality (discrimination and association by SOFA concordance category)
Methodological detailsmulticentre, external validation in MIMIC-IV database
- Multicentre
- External validation in MIMIC-IV database
Main finding
As reported in the abstract
In-hospital mortality
Each group vs SOFA-1(-)/SOFA-2(-)Hazard ratio (95% CI)
SOFA-1(+)/SOFA-2(-)
0.99(0.72–1.36)
SOFA-1(-)/SOFA-2(+)
3.52(2.66–4.67)
SOFA-1(+)/SOFA-2(+)
4.44(3.52–5.60)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Discrimination for in-hospital mortality (AUROC) | SOFA-2 AUROC 0.746 (95% CI 0.737–0.756) · SOFA-1 AUROC 0.679 (95% CI 0.668–0.689) |
| Distribution of SOFA concordance categories | SOFA-1(+)/SOFA-2(+) 74.2% (95% CI 73.6%–74.7%) · SOFA-1(+)/SOFA-2(-) 9.9% (95% CI 9.53%–10.2%) · SOFA-1(-)/SOFA-2(+) 5.5% (95% CI 5.2%–5.8%) · SOFA-1(-)/SOFA-2(-) 10.2% (95% CI 9.8%–10.6%) |
Distribution of SOFA concordance categories
- SOFA-1(-)/SOFA-2(+) patients younger, more often male, higher rates of pneumonia, gastrointestinal and neurologic infection
Original publication
Performance of sequential organ failure assessment 1 versus 2 for sepsis identification in patients with suspected infection: a multicenter retrospective cohort study. Crit Care. Published 26 April 2026. doi:10.
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