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Sequential Assessment of Multiple Organ Dysfunction as a Predictor of Outcome—Reply

Christian Mélot, MD, PhD, MSciBiostat; Flavio Lopes-Ferreira, MD; Jean-Louis Vincent, MD, PhD
JAMA. 2002;287(6):713-714. doi:10.1001/jama.287.6.711.
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In Reply: In response to Dr Pettilä, we used the ICU mortality rate as our outcome measure, as the SOFA score is only used in the intensive care setting. The attending physicians were unaware of the daily SOFA scores, and the data collectors were not involved in patient care or decision making.

We agree that the highest and mean SOFA scores, as well as the total SOFA score, are biased in favor of death (even though we excluded data obtained during the agonal period). For that reason, in addition to the fact that these scores correlate highly with the other SOFA scores, we did not include them in the multiple logistic regression presented herein.

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