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SOFA Score

Sequential Organ Failure Assessment — quantify organ dysfunction in critically ill patients. An acute increase of ≥ 2 points from baseline is used to identify sepsis (Sepsis-3).

Inputs — select score for each organ system

Respiration — PaO₂/FiO₂ (mmHg)

Coagulation — Platelets (×10³/µL)

Liver — Bilirubin (mg/dL)

Cardiovascular — Hypotension Vasopressor doses in µg/kg/min.

CNS — Glasgow Coma Scale

Renal — Creatinine (mg/dL) or urine output

SOFA Score (0–24)

Low organ dysfunction

Estimated ICU mortality—

Interpretation—

Disclaimer: For educational purposes only. Not a substitute for clinical judgment. Sepsis-3 defines sepsis as infection + acute SOFA increase ≥ 2 from baseline.

Organ system scoring

Respiration: PaO₂/FiO₂ ratio (0–4 pts)
Coagulation: Platelet count (0–4 pts)
Liver: Bilirubin (0–4 pts)
Cardiovascular: MAP or vasopressor need (0–4 pts)
CNS: Glasgow Coma Scale (0–4 pts)
Renal: Creatinine or urine output (0–4 pts)

Mortality estimates by SOFA

0–1: < 3.3%
2–3: ~6.4%
4–5: ~11.5%
6–7: ~18.2%
8–9: ~26.3%
10–11: ~35.5%
12–14: ~50%
≥ 15: > 80%

Clinical pearls

Sepsis-3 (2016): sepsis = suspected infection + acute SOFA ≥ 2 from baseline.
Septic shock: sepsis + vasopressors needed + lactate > 2 mmol/L despite adequate resuscitation.
Serial SOFA scores track trajectory — rising scores indicate worsening organ dysfunction.
Baseline SOFA assumed to be 0 in patients not known to have pre-existing organ dysfunction.

References

Vincent JL, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707–710.
Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.