Survey of Glasgow Coma Scale and PaO/FIO ratio assessment methods for the Sequential Organ Failure Assessment score in Japanese intensive care units.

Aim: Accurately calculating the Sequential Organ Failure Assessment (SOFA) score is essential for medical resource allocation and decision-making. This study surveyed Japanese intensive care units regarding their assessment of the Glasgow Coma Scale (GCS) and PaO/FIO ratio, components of the SOFA score.

Methods: A cross-sectional, web-based survey was conducted among healthcare workers. The survey consisted of questions about the intensive care units where they work and questions for respondents. It was distributed to healthcare workers by e-mail through the Japanese Society of Intensive Care Medicine mailing list and social networking service.

Results: Among 414 responses, we obtained 211 valid responses and 175 survey results from unique intensive care units. When assessing GCS in patients under the influence of sedatives, 45.1% (95% confidence interval, 37.6-52.8) of intensive care units assessed GCS assuming that the sedatives had no influence. For the PaO/FIO ratio in the SOFA score, calculation based on the Japanese Intensive Care Patient Database definition document and mechanical ventilator settings were the most common methods in patients with oxygen masks and on extracorporeal membrane oxygenation, respectively. Approximately 60% of respondents indicated that it was difficult to assess GCS assuming that sedatives had no influence.

Conclusion: In patients under the influence of sedatives, approximately half of the intensive care units assessed assumed GCS. There was variation in the methods used to assess the PaO/FIO ratio. Standardized assessment methods for GCS and the PaO/FIO ratio are needed to obtain valid SOFA score.