Sequential Organ Failure Assessment (SOFA) Score
SOFA is used to track a patient's status during ICU stay by quantifying the degree of organ dysfunction/failure across six organ systems. It is also used to define sepsis (Sepsis-3: SOFA increase ≥2 points from baseline).
Score 0 if ≥400; 1 if 300-399; 2 if 200-299; 3 if 100-199 with vent; 4 if <100 with vent
Score 0 if ≥150; 1 if 100-149; 2 if 50-99; 3 if 20-49; 4 if <20
Score 0 if <1.2; 1 if 1.2-1.9; 2 if 2.0-5.9; 3 if 6.0-11.9; 4 if ≥12.0
Score 0 if ≥70; cardiovascular score 1-4 based on vasopressor dose (see notes)
Score 0=none, 1=low-dose dopamine/dobutamine, 2=moderate, 3=high-dose vasopressors
Score 0 if 15; 1 if 13-14; 2 if 10-12; 3 if 6-9; 4 if <6
Score 0 if <1.2; 1 if 1.2-1.9; 2 if 2.0-3.4; 3 if 3.5-4.9; 4 if ≥5.0 OR urine output <200 mL/day
Optional: if <500 mL/day score 3; if <200 mL/day score 4 (overrides creatinine score if worse)
Note: Cardiovascular scoring: dopamine ≤5 or dobutamine = 1; dopamine >5 or epinephrine ≤0.1 or norepinephrine ≤0.1 µg/kg/min = 2; dopamine >15 or epinephrine >0.1 or norepinephrine >0.1 µg/kg/min = 3. For renal, urine output overrides creatinine if it yields a higher score.
SOFA Scoring Table (0-4 per organ system)
| System | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Respiratory (PaO2/FiO2) | ≥400 | 300-399 | 200-299 | 100-199 + vent | <100 + vent |
| Coagulation (Platelets) | ≥150 | 100-149 | 50-99 | 20-49 | <20 |
| Liver (Bilirubin mg/dL) | <1.2 | 1.2-1.9 | 2.0-5.9 | 6.0-11.9 | ≥12.0 |
| Cardiovascular | MAP ≥70 | Low-dose dopamine/dobutamine | Moderate vasopressors | High-dose vasopressors | |
| CNS (GCS) | 15 | 13-14 | 10-12 | 6-9 | <6 |
| Renal (Creatinine) | <1.2 | 1.2-1.9 | 2.0-3.4 | 3.5-4.9 | ≥5.0 or UO <200 |
Scoring Table
| Parameter | Points |
|---|---|
| Respiratory | >=400: 0 points 300-399: 1 points 200-299: 2 points 100-199_vent: 3 points <100_vent: 4 points |
| Coagulation | >=150: 0 points 100-149: 1 points 50-99: 2 points 20-49: 3 points <20: 4 points |
| Liver | <1.2: 0 points 1.2-1.9: 1 points 2.0-5.9: 2 points 6.0-11.9: 3 points >=12: 4 points |
| Cardiovascular | MAP>=70_no_vaso: 0 points low_dose_dopamine: 1 points moderate_vaso: 2 points high_vaso: 3 points |
| Cns | 15: 0 points 13-14: 1 points 10-12: 2 points 6-9: 3 points <6: 4 points |
| Renal | <1.2: 0 points 1.2-1.9: 1 points 2.0-3.4: 2 points 3.5-4.9: 3 points >=5: 4 points UO<500: 3 points UO<200: 4 points |
Interpretation
| Category | Score Range | Action |
|---|---|---|
| ● Mild Organ Dysfunction | 0-6 | Standard ICU care; monitor trends. |
| ● Moderate Organ Dysfunction | 7-9 | Active intervention; consider escalation. |
| ● Severe Organ Failure | 10-24 | Maximum support; high mortality risk. Mortality increases sharply with scores ≥8-10. |
References
- The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Medicine (1996). https://link.springer.com/article/10.1007/s001340050414
- Sepsis-3: The Third International Consensus Definitions for Sepsis and Septic Shock. JAMA (2016). https://jamanetwork.com/journals/jama/fullarticle/2492881
- Sequential Organ Failure Assessment (SOFA) Score. Merck Manual Professional Version (2024). https://www.merckmanuals.com/professional/critical-care-medicine/severity-of-illness-scoring/sequential-organ-failure-assessment-sofa-score
This calculator is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
- SOFA requires clinical judgment to interpret; scores should be trended over time rather than used as a single value.
- The cardiovascular component requires documentation of vasopressor doses; different agents have different scoring thresholds.
- Sepsis-3 defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalized as an increase in SOFA ≥2 points from baseline.
- SOFA was originally designed for ICU patients; its utility outside ICU is limited.