SOFA score

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SOFA score

Medical diagnostics

Purpose determine rate of organ failure

The sequential organ failure assessment score (SOFA score), previously known

as the sepsis-related organ failure assessment score,[1] is used to track a person's
status during the stay in an intensive care unit (ICU) to determine the extent of a
person's organ function or rate of failure. [2][3][4][5][6] The score is based on six different
scores, one each for
the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
The score tables below only describe points-giving conditions. In cases where the
physiological parameters do not match any row, zero points are given. In cases
where the physiological parameters match more than one row, the row with most
points is picked.
The quick SOFA score (qSOFA) assists health care providers in estimating the risk
of morbidity and mortality due to sepsis.[7]

Contents

 1Medical use
 2Scoring
o 2.1Respiratory system
o 2.2Nervous system
o 2.3Cardiovascular system
o 2.4Liver
o 2.5Coagulation
o 2.6Kidneys
 3Quick SOFA score
 4References
 5External links

Medical use[edit]
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill
patients.[8] According to an observational study at an Intensive Care Unit (ICU) in
Belgium, the mortality rate is at least 50% when the score is increased, regardless of
initial score, in the first 96 hours of admission, 27% to 35% if the score remains
unchanged, and less than 27% if the score is reduced. [9]
qSOFA has also been found to be poorly sensitive though decently specific for the
risk of death with SIRS possibly better for screening. [10]

Scoring[edit]
Respiratory system[edit]

PaO2/FiO2 [mmHg (kPa)] SOFA score

≥ 400 (53.3) 0

< 400 (53.3) +1

< 300 (40) +2

< 200 (26.7) and mechanically
+3
ventilated

< 100 (13.3) and mechanically
+4
ventilated

Nervous system[edit]

Glasgow coma
SOFA score
scale

15 0

13–14 +1

10–12 +2

6–9 +3

< 6 +4
Cardiovascular system[edit]

SOFA
Mean arterial pressure OR administration of vasopressors required
score

MAP ≥ 70 mmHg 0

MAP < 70 mmHg +1

dopamine ≤ 5 μg/kg/min or dobutamine (any dose) +2

dopamine > 5 μg/kg/min OR epinephrine ≤ 0.1 μg/kg/min
+3
OR norepinephrine ≤ 0.1 μg/kg/min

dopamine > 15 μg/kg/min OR epinephrine > 0.1 μg/kg/min OR
+4
norepinephrine > 0.1 μg/kg/min

Liver[edit]

Bilirubin (mg/dl)
SOFA score
[μmol/L]

< 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

Coagulation[edit]

Platelets×103/μl SOFA score

≥ 150 0

< 150 +1

< 100 +2

< 50 +3

< 20 +4

Kidneys[edit]

Creatinine (mg/dl) [μmol/L] (or urine

SOFA score
output)

< 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 < 500 ml/d) +3

> 5.0 [> 440] (or < 200 ml/d) +4

Quick SOFA score[edit]

The Quick SOFA Score (quickSOFA or qSOFA) was introduced by the Sepsis-3
group in February 2016 as a simplified version of the SOFA Score as an initial way to
identify patients at high risk for poor outcome with an infection. [11] The SIRS Criteria
definitions of sepsis are being replaced as they were found to possess too many
limitations; the "current use of 2 or more SIRS criteria to identify sepsis was
unanimously considered by the task force to be unhelpful." The qSOFA simplifies the
SOFA score drastically by only including its 3 clinical criteria and by including "any
altered mentation" instead of requiring a GCS <15. qSOFA can easily and quickly be
repeated serially on patients.
 Assessment qSOFA score

Low blood pressure (SBP ≤ 100

1
mmHg)

High respiratory rate (≥ 22 breaths/min) 1

Altered mentation (GCS ≤ 14) 1

The score ranges from 0 to 3 points. The presence of 2 or more qSOFA points near
the onset of infection was associated with a greater risk of death or prolonged
intensive care unit stay. These are outcomes that are more common in infected
patients who may be septic than those with uncomplicated infection. Based upon
these findings, the Third International Consensus Definitions for Sepsis recommends
qSOFA as a simple prompt to identify infected patients outside the ICU who are likely
to be septic.[12]

References[edit]
1. ^ Singer, Mervyn; et al. (23 February 2016).  "The Third International
Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)". JAMA.
p. 801.  doi:10.1001/jama.2016.0287. Retrieved  24 November2018.
2. ^ Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H,
Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure
Assessment) score to describe organ dysfunction/failure. On behalf of the Working
Group on Sepsis-Related Problems of the European Society of Intensive Care
Medicine. Intensive Care Med 1996 Jul;22(7):707-10. PMID 8844239.
3. ^ Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM,
Sprung CL, Colardyn F, Blecher S. Use of the SOFA score to assess the incidence
of organ dysfunction/failure in intensive care units: results of a multicenter,
prospective study. Working group on "sepsis-related problems" of the European
Society of Intensive Care Medicine. Crit Care Med 1998 Nov;26(11):1793-
800. PMID 9824069.
4. ^ Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, Takala
J, Sprung C, Antonelli M, Bruining H, Willatts S. The use of maximum SOFA score to
quantify organ dysfunction/failure in intensive care. Results of a prospective,
multicentre study. Working Group on Sepsis related Problems of the ESICM.
Intensive Care Med 1999 Jul;25(7):686-96. PMID 10470572.
5. ^ de Mendonça A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli
M, Takala J, Sprung C, Cantraine F. Acute renal failure in the ICU: risk factors and
outcome evaluated by the SOFA score. Intensive Care Med 2000 Jul;26(7):915-
21. PMID 10990106.
6. ^ 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 Oct
10;286(14):1754-8. PMID 11594901.
 7. ^ "National Inpatient Hospital Costs: The Most Expensive Conditions by
Payer, 2013". www.hcup-us.ahrq.gov. Rockville, MD: Agency for Healthcare
Research and Quality. Retrieved  2017-01-07.
8. ^ Vincent, JL; de Mendonca, A; Cantraine, F; Monero, R; Takala, J; Suter,
PM; Sprung, CL (November 1998). "Use of the SOFA score to assess the incidence
of organ dysfunction/failure in intensive care units: results of a multicenter,
prospective study. Working group on "sepsis-related problems" of the European
Society of Intensive Care Medicine".  Critical Care Medicine.  26  (11): 1793–
800.  doi:10.1097/00003246-199811000-00016.  PMID  9824069.
9. ^ Ferreira, FL; Bota, DP; Bross, A; Melot, C; Vincent, JL (10 October 2001).
"Serial evaluation of the SOFA score to predict outcome in critically ill
patients".  Journal of the American Medical Association. 286 (14): 1754–
1758.  doi:10.1001/jama.286.14.1754.  PMID  11594901.
10. ^ Fernando, Shannon M.; Tran, Alexandre; Taljaard, Monica; Cheng, Wei;
Rochwerg, Bram; Seely, Andrew J.E.; Perry, Jeffrey J. (6 February 2018).
"Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for
Mortality in Patients With Suspected Infection". Annals of Internal Medicine. 168 (4):
266.  doi:10.7326/M17-2820.
11. ^ Angus, Derek C.; Seymour, Christopher W.; Coopersmith, Craig M.;
Deutschman, Clifford S.; Klompas, Michael; Levy, Mitchell M.; Martin, Gregory S.;
Osborn, Tiffany M.; Rhee, Chanu. "A Framework for the Development and
Interpretation of Different Sepsis Definitions and Clinical Criteria".  Critical Care
Medicine. 44 (3): e113–e121.  doi:10.1097/ccm.0000000000001730. PMC  4765912.
12. ^ "qSOFA  :: What is qSOFA?". www.qsofa.org. Retrieved  2016-05-29.

External links[edit]
 Janssens U, et al. Value of SOFA (Sequential Organ Failure Assessment)
score and total maximum SOFA score in 812 patients with acute cardiovascular
disorders [abstract]. Crit Care 2001;5(Suppl 1):P225.

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