Addition of HbA1c to SOFA score for predicting outcomes in diabetic patients with sepsis and septic shock

Panduranga G, Prasad DESRKD, Kanagula S, Sahu S

Pdf Page Numbers :- 172-178

Gautam Panduranga^1,*, Prasad DESRKD², Shivaraju Kanagula² and Sambit Sahu³

¹Department of General Medicine, Mediciti Institute of Medical Sciences, Ghanpur- 501401, Telangana, India

²Department of General Medicine, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

³Critical and Intensive Care, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Gautam Panduranga, Department of General Medicine, Mediciti Institute of Medical Sciences, Ghanpur- 501401, Telangana, India. Email: gautampsetty@yahoo.com

Received 6 June 2022; Revised 16 August 2022; Accepted 30 August 2022; Published 6 September 2022

Citation: Panduranga G, Prasad DESRKD, Kanagula S, Sahu S. Addition of HbA1c to SOFA score for predicting outcomes in diabetic patients with sepsis and septic shock. J Med Sci Res. 2022; 10(4):172-178. DOI: http://dx.doi.org/10.17727/JMSR.2022/10-32

Copyright: © 2022 Panduranga G et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Sepsis is a common cause of admissions into intensive care units (ICU’s). SOFA (sequential organ failure assessment) score has been validated as a prognostic marker in sepsis and there’s a good correlation between SOFA scoring and mortality of patients. Diabetes is a well-known predisposing factor for sepsis and we studied whether addition of HbA1c to SOFA score was helpful in predicting outcomes in diabetic patients with sepsis and septic shock. H-SOFA max score (HbA1c score added to maximum SOFA measured on any day of hospital stay) was the best predictor for in-hospital mortality. The mean H-SOFA (Max) score in the died (in-hospital mortality) group was 12.21 (±2.78), and in the discharged group was 5.49 (±2.68). Next best predictor was H-SOFA score (HbA1c score added to SOFA score at admission), followed by SOFA score. All the scores had a positive correlation with length of ICU stay. HbA1c (indicator of glycemic control) was helpful in predicting mortality when combined with the SOFA score (but not by itself). These scores may therefore be helpful to physicians and intensivists for prognostication of the patient and during counselling of the relatives, including end of life discussions.

Keywords: sepsis; sequential organ failure; SOFA score; HbA1c; diabetes mellitus; mortality