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    Sequential Organ Failure Assessment (SOFA) Score

    Predicts ICU mortality based on lab results and clinical data.

    IMPORTANT

    We launched a COVID-19 Resource Center, including a critical review of recommended calcs.

    Tips for COVID-19: Use for Crisis Standards of Care. Proposed by New York State 2015 Guidelines for Ventilator Allocations for Flu Pandemics. Shown to correlate to mortality in COVID-19 (OR 5.65) (Zhou 2020).

    INSTRUCTIONS

    Welcome Sepsis-3 readers! We've also added the qSOFA Score with a summary of the new definitions and recommendations.

    Use the worst value in a 24-hour period.

    When to Use
    Pearls/Pitfalls
    Why Use
    • The SOFA Score can be used on all patients admitted to an intensive care unit.
    • It is not clear if the score can be reliably used in patients that were transferred from another ICU.
    • The Sequential Organ Failure Assessment (SOFA) Score is a mortality prediction score that is based on the degree of dysfunction of six organ systems.
    • The score is calculated on admission and every 24 hours until discharge using the worst parameters measured during the prior 24 hours.
    • The scores can be used in a number of ways:
      • As individual scores for each organ to determine progression of organ dysfunction.
      • As the sum of scores on one single ICU day.
      • As the sum of the worst scores during the ICU stay.
    • It is believed to provide a better stratification of the mortality risk in ICU patients given that the data used to calculate the score is not restricted to admission values.

    Tips from creator Dr. Jean-Louis Vincent:

    • The respiratory dysfunction component is often misunderstood. The patient needs to have some respiratory support (mechanical ventilation or CPAP) to have a respiratory score of 3 or 4 (to make sure it is not just some minor atelectasis), but not the other way around: a comatose patient may need mechanical ventilation and yet have no significant hypoxemia.
    • It is also important to realize that the neurological score in sedated/anesthetized patients corresponds with the GCS that the patient would have in the absence of medications (i.e., assumed GCS).

    The SOFA Score can be used to determine level of organ dysfunction and mortality risk in ICU patients.

    mm Hg
    %
    No
    Yes
    ≥150
    0
    100-149
    +1
    50-99
    +2
    20-49
    +3
    <20
    +4
    15
    0
    13-14
    +1
    10-12
    +2
    6-9
    +3
    <6
    +4
    <1.2 (<20)
    0
    1.2–1.9 (20-32)
    +1
    2.0–5.9 (33-101)
    +2
    6.0–11.9 (102-204)
    +3
    ≥12.0 (>204)
    +4
    No hypotension
    0
    MAP <70 mmHg
    +1
    DOPamine ≤5 or DOBUTamine (any dose)
    +2
    DOPamine >5, EPINEPHrine ≤0.1, or norEPINEPHrine ≤0.1
    +3
    DOPamine >15, EPINEPHrine >0.1, or norEPINEPHrine >0.1
    +4
    <1.2 (<110)
    0
    1.2–1.9 (110-170)
    +1
    2.0–3.4 (171-299)
    +2
    3.5–4.9 (300-440) or UOP <500 mL/day
    +3
    ≥5.0 (>440) or UOP <200 mL/day
    +4
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Jean-Louis Vincent

    About the Creator

    Jean-Louis Vincent, MD, is a professor of intensive care at the University of Brussels and the head of the Department of Intensive Care at Erasme University Hospital, Brussels. He is an organizer of the International Symposium on Intensive Care and Emergency Medicine. Dr. Vincent researches sepsis, acute circulatory failure (circulatory shock) and its treatment, oxygen transport, haemodynamic monitoring, vital emergencies and ethical aspects of intensive care.

    To view Dr. Jean-Louis Vincent's publications, visit PubMed

    Are you Dr. Jean-Louis Vincent? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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