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Sequential Organ Failure Assessment (SOFA) Score
SOFA
Evaluates organ dysfunction and sepsis severity in critical care
Sequential Organ Failure Assessment (SOFA) Score
SOFA
Evaluates organ dysfunction and sepsis severity in critical care
Instructions
The SOFA score is used to assess the severity of organ dysfunction in critically ill patients. Enter values for respiratory, coagulation, liver, cardiovascular, central nervous system, and renal parameters. Each organ system is scored from 0 to 4, and the total SOFA score is calculated.
Overview
When to use
Why use
Evidences
Interpretation
SOFA Score | Interpretation |
0–6 | Mild organ dysfunction, lower risk |
7–9 | Moderate dysfunction, increased monitoring required |
10–12 | Significant dysfunction, high risk of poor outcome |
>12 | Severe multi-organ failure, very high mortality risk |
Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707–710. Introduced a 6‑organ, 0–4 point system (respiratory, coagulation, liver, cardiovascular, CNS, renal) for serial assessment; higher scores associated with increased ICU mortality.
https://link.springer.com/article/10.1007/BF01709751
Vincent JL, de Mendonça A, Cantraine F, et al. Use of the SOFA score to assess incidence of organ dysfunction/failure in ICUs: multicenter, prospective study. Crit Care Med. 1998;26(11):1793–1800. Established incidence and mortality gradients across SOFA strata; supported routine serial scoring in ICU cohorts.
https://journals.lww.com/ccmjournal/abstract/1998/11000/use_of_the_sofa_score_to_assess_the_incidence_of.16.aspx
Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754–1758. Both admission SOFA and ΔSOFA over 48h predicted ICU mortality; rising SOFA linked to worse outcomes, falling SOFA to recovery.
https://jamanetwork.com/journals/jama/fullarticle/194262?resultClick=1
Moreno R, Vincent JL, Matos R, et al. Maximum SOFA score to quantify organ dysfunction/failure in intensive care. Intensive Care Med. 1999;25(7):686–696. Maximum SOFA strongly associated with mortality; cumulative organ dysfunction burden matters.
https://link.springer.com/article/10.1007/s001340050931
Overview
When to use
Why use
Evidences
The Sequential Organ Failure Assessment (SOFA) score is a widely used clinical tool that evaluates the extent of organ dysfunction in critically ill patients, particularly those with suspected or confirmed sepsis. First introduced in the 1990s by the European Society of Intensive Care Medicine, it has become an essential part of critical care practice and research.
SOFA is based on six organ systems: respiratory, coagulation, liver, cardiovascular, central nervous system, and renal. Each system is assigned a score from 0 (normal function) to 4 (severe dysfunction or failure), depending on specific clinical or laboratory parameters such as PaO₂/FiO₂ ratio, platelet count, bilirubin, mean arterial pressure or vasopressor use, Glasgow Coma Scale (GCS), creatinine, and urine output. The scores are added to provide a total ranging from 0 to 24.
The SOFA score is not only useful for daily monitoring in intensive care units but also for predicting outcomes in sepsis and other critical illnesses. A rising SOFA score is strongly associated with increased mortality risk, while stable or decreasing scores indicate better prognosis.
Overview
When to use
Why use
Evidences
Interpretation
SOFA Score | Interpretation |
0–6 | Mild organ dysfunction, lower risk |
7–9 | Moderate dysfunction, increased monitoring required |
10–12 | Significant dysfunction, high risk of poor outcome |
>12 | Severe multi-organ failure, very high mortality risk |
Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707–710. Introduced a 6‑organ, 0–4 point system (respiratory, coagulation, liver, cardiovascular, CNS, renal) for serial assessment; higher scores associated with increased ICU mortality.
https://link.springer.com/article/10.1007/BF01709751
Vincent JL, de Mendonça A, Cantraine F, et al. Use of the SOFA score to assess incidence of organ dysfunction/failure in ICUs: multicenter, prospective study. Crit Care Med. 1998;26(11):1793–1800. Established incidence and mortality gradients across SOFA strata; supported routine serial scoring in ICU cohorts.
https://journals.lww.com/ccmjournal/abstract/1998/11000/use_of_the_sofa_score_to_assess_the_incidence_of.16.aspx
Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754–1758. Both admission SOFA and ΔSOFA over 48h predicted ICU mortality; rising SOFA linked to worse outcomes, falling SOFA to recovery.
https://jamanetwork.com/journals/jama/fullarticle/194262?resultClick=1
Moreno R, Vincent JL, Matos R, et al. Maximum SOFA score to quantify organ dysfunction/failure in intensive care. Intensive Care Med. 1999;25(7):686–696. Maximum SOFA strongly associated with mortality; cumulative organ dysfunction burden matters.
https://link.springer.com/article/10.1007/s001340050931
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