Using research to prepare for outbreaks of severe acute respiratory infection

Increasing SOFA score on presentation was associated with increasing mortality (27% increase in mortality for every additional SOFA score point; figure 3 ). The highest organ dysfunction scores were in patients in the East Asia and Pacific (57.5% having scores between 8-11% and 48%, with scores of more than 12) and North America (35% having scores between 8-11% and 24%, with scores of more than 12; figure 4 ). In children, full data on the adapted SOFA score were available in only 122 of 220 patients aged less than 10 years, with only 2 dying, leading to an inability to perform association studies between organ dysfunction and hospital mortality. Missing complete data for organ dysfunction (n=122) were exclusively focused on lower income regions, with greater missing data among children. Univariate and multivariate logistic regressions were used to assess the association between mortality and main a priori proposed risk factors or adjusting for potential confounders (table 2). We identified that SOFA score at admission and increasing age were independent predictors of hospital mortality across all age groups, where SOFA scores were available. After adjusting for potential confounders, increasing SOFA score was associated with increased mortality, when compared with those with a SOFA score ≤3: SOFA 4-7 (OR=3.57 (95% CI 1.08 to 11.81), p=0.04), SOFA 8-11 (OR=2.95 (95% CI 0.71 to 12.23), p=0.14) and SOFA ≥12 (OR=12.74 (95% CI 2.86 to 56.69), p=0.001). There was a 3% increased risk of mortality for every yearly increase in age (adjusted OR=1.03 (95% CI 1.01 to 1.05), p<0.001). Analysis by year showed no significant differences between analyses restricted to 2016 or 2017 seasons.