{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T18:12:42Z","timestamp":1794334362244,"version":"4.9.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hellenic Institute for the Study of Sepsis"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Since the Sepsis-3 criteria, change in Sequential Organ Failure Assessment (SOFA) score has become a key component of sepsis identification. Thus, it could be argued that reversal of this change (\u0394\n                      <jats:sub>SOFA<\/jats:sub>\n                      ) may reflect sepsis response and could be used as measure of efficacy in interventional trials. We aimed to assess the predictive performance of \u0394\n                      <jats:sub>SOFA<\/jats:sub>\n                      for 28-day mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from two previously published randomized controlled trials were studied: the first reporting on patients with severe Gram-negative infections as a derivation cohort and the second reporting on patients with ventilator-associated pneumonia as a validation cohort. Only patients with sepsis according to the Sepsis-3 definition were included in this analysis. SOFA scores were calculated on days 1, 2, 3, 5, 7, 14, and 28.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 448 patients within the derivation cohort and 199 within the validation cohort. Mean SOFA scores on day 1 were 6.06\u2009\u00b1\u20094.07 and 7.84\u2009\u00b1\u20093.39, and 28\u2009day mortality 22.8% and 29.6%, respectively. In the derivation cohort, the earliest time point where \u0394\n                      <jats:sub>SOFA<\/jats:sub>\n                      score predicted mortality was day 7 (AUROC (95% CI) 0.84 (0.80\u20130.89);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The best tradeoff for prediction was found with 25% changes (78% sensitivity, 80% specificity); less than 25% decrease of admission SOFA was associated with increased mortality (odds ratio for death 14.87). This finding was confirmed in the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      \u0394\n                      <jats:sub>SOFA<\/jats:sub>\n                      on day 7 is a useful early prognostic marker of 28-day mortality and could serve as an endpoint in future sepsis trials alongside mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      numbers NCT01223690 and NCT00297674\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-019-2665-5","type":"journal-article","created":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T14:02:26Z","timestamp":1575036146000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["The early change of SOFA score as a prognostic marker of 28-day sepsis mortality: analysis through a derivation and a validation cohort"],"prefix":"10.1186","volume":"23","author":[{"given":"Eleni","family":"Karakike","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evdoxia","family":"Kyriazopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iraklis","family":"Tsangaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Routsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Vincent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-3911","authenticated-orcid":false,"given":"Evangelos J.","family":"Giamarellos-Bourboulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,29]]},"reference":[{"key":"2665_CR1","doi-asserted-by":"publisher","first-page":"2055","DOI":"10.1056\/NEJMoa1202290","volume":"366","author":"VM Ranieri","year":"2012","unstructured":"Ranieri VM, Thompson BT, Barie PS, Dhainaut JF, Douglas IS, Finfer S, et al. 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The derivation cohort resulted from a study approved by the Central Ethics Committee (EED), Athens, Greece (approval 42797\/20-06-2007), and the National Organization for Medicines (EOF), Athens, Greece (approval 76305\/15-02-2007), and was conducted according to the Declaration of Helsinki. EudraCT number 2006-004886-33. The validation cohort came from a study approved by the National Organization for Medicines of Greece (approval 14653\/14-6-2004) that was conducted according to the Declaration of Helsinki.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"E Karakike is funded by the Horizon 2020 Marie Sk\u0142odowska-Curie Grant European Sepsis Academy (grant 676129 paid to the University of Athens).EJ Giamarellos-Bourboulis has received honoraria (paid to the University of Athens) from AbbVie USA, Abbott CH, Biotest Germany, Brahms GmbH, InflaRx GmbH, the Medicines Company, MSD Greece, and XBiotech Inc. He has received independent educational grants from AbbVie, Abbott, Astellas Pharma, AxisShield, bioM\u00e9rieux Inc., InflaRx GmbH, the Medicines Company, and XBiotech Inc. He has received funding from the FrameWork 7 program HemoSpec and from the Horizon 2020 Marie-Curie project European Sepsis Academy (granted to the National and Kapodistrian University of Athens), outside the submitted work.The other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"387"}}