改訂SOFAスコア（SOFA-2スコア）：解説
DOI:
https://doi.org/10.51094/jxiv.1929キーワード:
臓器障害、 日本ICU患者データベース、 デルファイ法、 妥当性検証抄録
SOFA（Sepsis-related Organ Failure Assessment）スコアは1996年に発表され、名称のSepsis-relatedの部分がSequentialに変更され、重症患者の臓器障害を簡便かつ経時的に定量評価する指標として広く活用されてきた。しかし約30年が経ち、現在の医療に合うスコアへと改訂が求められるようになった。そこで世界各地の関係専門家60名以上から成るプロジェクトチームが構成され、スコアの改訂が行われた。
改訂プロセスでは、定義と指標の選定について修正デルファイ法による合意形成に続き、大規模なICU患者データに基づく妥当性検証が行われた。SOFA-2では6臓器別（脳・呼吸・心血管・肝・腎・止血）の評価指標とポイントがそれぞれ見直された。慢性臓器障害、せん妄、機械的臓器補助、さまざまな昇圧薬併用の反映やカットオフ値の変更などが主要な改訂であった。予測的妥当性検証の結果、SOFA-2のICU死亡予測能はSOFA-1と同等以上であった。
本稿では、この改訂プロジェクトに携わった著者らがSOFA-2開発の背景、経緯、改訂点、妥当性検証（日本のJIPADデータを含む）、および今後の展望について概説する。
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投稿日時: 2025-11-07 11:53:28 UTC
公開日時: 2025-11-13 01:24:16 UTC
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Copyright（c）2025
藤井, 智子
田中, 司朗
小針, 成敬
橋本, 悟
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