Sofa score

SOFA is an acronym for "Sequential Organ Failure Assessment". It represents a consensus established by experts of the European Society for Intensive Care Medicine (ESICM) for the objective description of organ (dys)function. The daily survey (24-hour periods) is based on the worst values for each organ system.

For the SOFA score, six organs or organ systems are assessed using specific parameters. For each system, points of 0 (normal function) and 4 (severely impaired function) are awarded.

Breathing activity

• PaO2/FiO2 (mmHg)
• < 400: 1point
• < 300: 2 points
• < 200 and ventilation: 3 points
• < 100 and ventilation: 4 points

Central Nervous System (Glasgow Coma Score)

• 13-14: 1-point
• 10-12: 2 points
• 6-9: 3 points
• <6: 4 points
• Cardiovascular

mean arterial blood pressure (MAP) or use of vasopressors

• MAP: < 70 mmHg: 1point
• Dopamine: ≤ 5 µg/kg/min or dobutamine (dosage not important): 2 points
• Dopamine: > 5 µg/kg/min or adrenalin ≤ 0,1 µg/kg/min or noradrenalin ≤ 0,1 µg/kg/min: 3 points
• Dopamine: > 15 µg/kg/min or adrenalin > 0,1 µg/kg/min or noradrenalin > 0,1 µg/kg/min: 4 points

Liver function

• Bilirubin: 1.2 -1.9 mg/dl: 1point
• Bilirubin: 2.0 - 5.9 mg/dl: 2 points
• Bilirubin: 6.0 - 11.9 mg/dl: 3 points
• Bilirubin: >12.0 mg/dl: 4 points

Blood Coagulation

• Platelets × 103/µl: < 150: 1 point
• Platelets × 103/µl: < 100: 2 points
• Platelets × 103/µl: < 50: 3 points
• Platelets × 103/µl:< 20: 4 points

Renal function

• Creatinine: 1.2 - 1.9 mg/dl: 1 point
• Creatinine: 2.0 - 3.4 mg/dl: 2 points
• Creatinine: 3.5 - 4.9 mg/dl: 3 points
• Creatinine: > 5 mg/dl: 4 points

The SOFA score is determined every 24 hours. The development of the score in the course of intensive care treatment provides information about the mortality risk. Both the sum of the points and the point development of the individual organs can be considered.

The output SOFA Score can be assumed to be zero in patients with no known organ dysfunction. A SOFA score ≥ 2 reflects a mortality ≥ 10% in a general hospital population with suspected infection. Patients with only mild organ dysfunction can also be expected to deteriorate further. This illustrates the risk of sepsis and the need for prompt and adequate intervention, if not already initiated

A simplified form of the SOFA score is the qSOFA score.

1. Seymour CW et al (2016) Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:762-774.
2. Seymour C et al (2016) Quick SOFA (qSOFA) JAMA 315:762-774
3. Seymour CW et al (2016) Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:762-774.
4. Singer M et al (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:801-10.