Navigating mysterious lands regarding the predictive value of the SOFA score: the race dilemma

Navegando por un territorio misterioso en cuanto al valor predictivo de la puntuación del SOFA: el dilema de la raza


  • Ivan D. Lozada Martinez Centro de Investigaciones Médico-Quirúrgicas, Capitulo Futuros Cirujanos, Asociación Colombiana de Cirugía, Bogotá, Colombia
  • Stefhany Hernandez Muñoz Facultad de Medicina, Universidad Santiago de Cali, Cali, Colombia
  • Ailyn Z. Angulo Lara Facultad de Medicina, Universidad Libre, Barranquilla, Colombia
  • Estefanía Ruiz Benítez Facultad de Medicina, Universidad del Rosario, Bogotá, Colombia
  • Cindy S. Buitrago Almanza Facultad de Medicina, Universidad Nacional, Colombia, Colombia
  • Jhon A. Hernández Gallego Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
  • Laura C. Carreño Mancilla Facultad de Medicina, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
  • Nathalia C. Ordóñez Veloza Facultad de Medicina, Universidad de Manizales, Manizales, Colombia
  • Yohan S. Reyes Triviño Facultad de Medicina, Fundación Universitaria Juan N. Corpas, Bogotá, Colombia



Organ dysfunction scores, Continental population groups, Predictive value of tests, Critical care outcomes


Critical syndromes are conditions that carry a high global burden of disease. Scoring systems are practical and reproducible aids that allow patients with more severe disease to be quickly identified and admitted to intensive care and to initiate structured and aggressive therapy. The Sequential Organ Failure Assessment (SOFA) score is one of the most widely used in the world, as there are several versions and it is simple. However, with the appearance of the COVID-19, several studies showed that there was a disparity in the estimation of mortality and associated outcomes, with respect to race, which culminated in an excess of preventable mortality in certain racial groups. Constant evaluation of the performance of these scoring systems must be performed due to definitional updates, which may vary the accuracy of the predictive value. There is a very large evidence gap in this regard, as the existing studies are from high-income countries where the predominant racial group is Caucasian, which should draw attention to the magnitude of the problem. Based on the above, the objective of this review is to discuss evidence on the performance of critical care scoring systems, particularly SOFA, and the impact that race has had on its predictive value.


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