Publication Type
Journal Article
Version
acceptedVersion
Publication Date
12-2025
Abstract
Purpose: Real-time risk monitoring is critical but challenging in intensive care units (ICUs) due to the lack of real-time updates for most clinical variables. Although real-time predictions have been integrated into various risk-scoring systems to aid monitoring, existing systems do not address uncertainties in risk assessments. We developed an enhanced risk monitoring framework based on commonly used systems like the Sequential Organ Failure Assessment (SOFA) score by incorporating uncertainties to improve the effectiveness of real-time risk monitoring in ICUs.Methods: This study included 5,351 patients admitted to the Cardiothoracic ICU in the National University Hospital in Singapore. We developed machine learning models to predict long lead-time variables and computed real-time SOFA scores using these predictions. We calculated intervals to capture uncertainties in risk assessments and validated the association of the estimated real-time scores and intervals with mortality and readmission.Results: Our model outperforms the SOFA score in predicting 24-hour mortality: Nagelkerke’s R-squared (0.224 vs. 0.185, p Conclusions: Incorporating uncertainties improved existing scores in real-time monitoring, which could be used to trigger on-demand laboratory tests, potentially improving early detection, reducing unnecessary testing, and thereby lowering healthcare expenditures, mortality, and readmission rates in clinical practice.
Keywords
Risk monitoring, SOFA score, qSOFA score, 24-hour mortality, readmission rate
Discipline
Databases and Information Systems | Health Information Technology
Research Areas
Operations Management; Intelligent Systems and Optimization
Publication
Health Information Science and Systems
Volume
13
First Page
1
Last Page
10
ISSN
2047-2501
Identifier
10.1007/s13755-024-00331-5
Publisher
Springer
Citation
HE, Yan; LUO, Qian; WANG, Hai; ZHENG, Zhichao; LUO, Haidong; and OOI, Oon Cheong.
Real-time estimated Sequential Organ Failure Assessment (SOFA) score with intervals: Improved risk monitoring with estimated uncertainty in health condition for patients in intensive care units. (2025). Health Information Science and Systems. 13, 1-10.
Available at: https://ink.library.smu.edu.sg/lkcsb_research/7639
Copyright Owner and License
Authors
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Additional URL
https://doi.org/10.1007/s13755-024-00331-5
