Introduction:

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 diseases to be quickly identified and admitted to intensive care and structured and aggressive therapy initiated. 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 COVID-19, several studies showed a disparity in the estimation of mortality and associated outcomes concerning race, culminating in excess of preventable mortality in certain racial groups. The constant evaluation of the performance of these scoring systems must be carried out due to definition updates, which can vary the accuracy of the predictive value. There is a very large gap in the evidence since the existing studies come from high-income countries, where the predominant racial group is Caucasians, 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 scoring systems in critical care, particularly SOFA, and the impact that race has had on its predictive value.

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