Objective:

To compare the SOFA score with the SOFA score and interleukin-6 level in predicting outcomes in ICU patients with sepsis.

Approach:

• Study Design: Prospective observational study conducted in a tertiary care ICU involving 40 adult patients with sepsis.
• Inclusion Criteria: Adult patients aged 18-50 years with sepsis (Sepsis-3 criteria) and anticipated ICU stay of >72 hours.
• Exclusion Criteria: Patients with acute coronary syndrome, terminal malignancy, major burns, elective postoperative ventilation, COVID-19, or inter-ICU transfer.
• Measurements: SOFA scores and serum IL-6 levels were measured at admission and at 24-hour intervals up to 72 hours.
• Follow-Up: Patients were followed for 15 days and classified as survivors or non-survivors.
• Analysis: Prognostic performance assessed using ROC analysis and bootstrap resampling for internal validation.

Key Findings:

• 60% of patients survived, while 40% died within 15 days.
• Non-survivors had significantly higher SOFA scores at admission compared to survivors (median 13 vs. 10, p = 0.006).
• IL-6 levels were consistently higher in non-survivors across Days 0-3 (p < 0.05).
• The combined SOFA-IL-6 score showed modest improvements in prognostic performance on Days 0-2 compared to SOFA alone (AUC improvements of +0.024 to +0.048).

Interpretation:

On Day 3, both the combined SOFA-IL-6 score and SOFA alone performed equivalently in predicting outcomes, as indicated by statistical analysis.

Limitations:

• Small sample size of 40 patients.
• Single-center study may limit generalizability.

Conclusion:

Combining the SOFA score with IL-6 showed modest improvements in early prognostication for critically ill patients with sepsis, particularly on Days 0-2.