Sofa Score Calculator

SOFA grades the severity of dysfunction in six organ systems on a 0 to 4 scale each, giving a total of 0 to 24. Respiration uses the PaO2/FiO2 ratio, with 3 and 4 points requiring mechanical ventilatory support. Coagulation uses platelet count, from 150 x 10^3/microL down to below 20. Liver uses total bilirubin, from under 1.2 mg/dL to 12.0 mg/dL or more. Cardiovascular is graded not by blood pressure alone but by vasopressor dose - mean arterial pressure below 70 mmHg scores 1, while norepinephrine or epinephrine above 0.1 micro-g/kg/min scores 4 - which encodes how much pharmacological support is needed to maintain perfusion. The central nervous system uses the Glasgow Coma Scale and renal function uses creatinine or urine output, with under 200 mL per day scoring 4. Each variable is the worst value in a 24-hour period. Serial measurement is where it performs best: the change from admission, often called delta-SOFA, discriminates outcome better than any one reading, and a rising score over the first 48 hours is a strong adverse signal. Under the Sepsis-3 definition an acute increase of 2 or more points in a patient with suspected infection defines sepsis, with an associated in-hospital mortality of roughly 10 percent, and a total of 15 or above is associated with mortality that commonly exceeds 80 percent. Interpretation requires care. The score assumes a baseline of zero unless chronic organ impairment is known, so chronic kidney disease or cirrhosis inflates the total without any acute event. The CNS component is unreliable in sedated or intubated patients.

SOFA was created at a consensus meeting of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine, held in Paris in October 1994. Jean-Louis Vincent of the Erasme University Hospital in Brussels led the effort, and the resulting description was published in Intensive Care Medicine in 1996 under the title The SOFA score to describe organ dysfunction/failure. The acronym originally stood for Sepsis-related Organ Failure Assessment; it was renamed Sequential Organ Failure Assessment once it became clear the instrument applied to critically ill patients generally, not only those with sepsis. The design brief was deliberately narrow - the group wanted a simple, objective, repeatable description of organ dysfunction over time, explicitly not a mortality prediction model like APACHE II or SAPS II. Validation followed in a 1998 multicentre study of roughly 1,400 ICU patients across 40 European units, which established the relationship between score and outcome. Flavio Lopes Ferreira and colleagues published the serial-evaluation work in JAMA in 2001, showing that the trend and the maximum score carried more prognostic information than the admission value. The score gained a second life in 2016 when the Sepsis-3 task force chose it as the operational definition of organ dysfunction in sepsis, which moved SOFA from a research and audit instrument into routine diagnostic use and prompted the derivation of the bedside qSOFA companion. Pediatric and neonatal adaptations followed, including pSOFA described by Matics and Sanchez-Pinto in 2017.