Sequential Organ Failure Assessment: SOFA Score

 

Input
 

PaO2		Pascal atm bar cmH2O cmHg ftH2O gm/sqcm inH2O inHg kPa mbar mmHg psi torr
FIO2		% fraction
Ventilatory Support	Yes (1)
	No (0)
Platelets		#/mcL #/microL / nl /mcL /microL 10E+9/L 10^3/microL Mill/mcl Thous/mcL X10E+09/L X10E+12/L cells/mcL cells/microL m/cmm x10(12)/L x10(3)/mcL x10(3)/microL x10(6)/L x10(6)/mcL x10(6)/microL x10(9)/L x1000/mm3 x10^12/L x10^3/mcL x10^3/microL x10^6/L x10^6/mcL x10^6/microL x10^9/L
Total Bilirubin		mcmol/L mg% mg/dL
Blood Pressure	Hypotension absent (0)
	Mean arterial pressure <70 mmHg (1)
	On Dopamine ≤5 mcg/kg/min or any Dobutamine (2)
	On Dopamine >5 mcg/kg/min, Epinephrine <=0.1 mcg/kg/min or Norepinephrine <=0.1 mcg/kg/min (3)
	On Dopamine >15 mcg/kg/min or Epinephrine >0.1 mcg/kg/min or Norepinephrine >0.1 mcg/kg/min (4)
Glasgow Coma Score		# index logit none number points score
Creatinine		mcmol/L mg/dL mmol/L
Urine Output		L/24H L/day mL/24H mL/day

 
Results
 

PaO2/FIO2		% fraction percent rate ratio
SOFA Score		# index logit none number points score

 

   
 
Include literature references: Yes   No

 

Notes

• Vasoactive drug dose criteria based on administration for at least one hour.
• The SOFA score helps predict morbidity rather than mortality, though individuals with a score of 15 or more had a mortality rate of 90%¹.

 
Equations used
 

PaO2/FIO2 = 100 * PaO2 / FIO2

SOFAScore = PaO2/FIO2Factor + PlateletsFactor + TotalBilirubinFactor + BloodPressure + GlasgowComaScoreFactor + RenalFactor

 

 

Calculation Details and Variables

• Equation parameters such as Ventilatory Support, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (1), represent the values that will be used.
• PlateletsFactor is assigned values by this ordered logic:
  • If Platelets <20 x10(3)/mcL PlateletsFactor = 4
  • Else if Platelets <50 x10(3)/mcL PlateletsFactor = 3
  • Else if Platelets <100 x10(3)/mcL PlateletsFactor = 2
  • Else if Platelets <150 x10(3)/mcL PlateletsFactor = 1
  • Else PlateletsFactor = 0.
• TotalBilirubinFactor is assigned values by this ordered logic:
  • If Total Bilirubin <1.2 mg/dL TotalBilirubinFactor = 0
  • Else if Total Bilirubin <2 mg/dL TotalBilirubinFactor = 1
  • Else if Total Bilirubin <6 mg/dL TotalBilirubinFactor = 2
  • Else if Total Bilirubin <12 mg/dL TotalBilirubinFactor = 3
  • Else TotalBilirubinFactor = 4.
• GlasgowComaScoreFactor is assigned values by this ordered logic:
  • If Glasgow Coma Score >14 points GlasgowComaScoreFactor = 0
  • Else if Glasgow Coma Score >12 points GlasgowComaScoreFactor = 1
  • Else if Glasgow Coma Score >9 points GlasgowComaScoreFactor = 2
  • Else if Glasgow Coma Score >5 points GlasgowComaScoreFactor = 3
  • Else GlasgowComaScoreFactor = 4.
• pafiFactor is assigned values by this ordered logic:
  • If PaO₂/FIO₂ ≤100 with Ventilatory Support pafiFactor = 4
  • Else if PaO₂/FIO₂ ≤200 with Ventilatory Support pafiFactor = 3
  • Else if PaO₂/FIO₂ ≤300 pafiFactor = 2
  • Else if PaO₂/FIO₂ ≤400 pafiFactor = 1
  • Else pafiFactor = 0
• RenalFactor is assigned values by this ordered logic:
  • If Creatinine <1.2 mg/dL RenalFactor = 0
  • Else if Creatinine <2 mg/dL RenalFactor = 1
  • Else if Creatinine <3.5 mg/dL RenalFactor = 2
  • Else if Creatinine <5 mg/dL RenalFactor = 3
  • Else RenalFactor = 4
• RenalFactor may also be set based on urine output:
  • If Urine Output <500 mL/day RenalFactor = 3
  • Else if Urine Output <200 mL/day RenalFactor = 4

 

References

1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. PubMed ID: 26903338
2. Vincent JL, de Mendonca A, Cantraine F, et al. 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. PubMed ID: 9824069

 

Associated Medical Subject Headings [MeSH]
 

Adult, Advisory Committees, Aged, Biomarkers, Blood Pressure, Delphi Technique, Female, Hospital Mortality, Humans, Incidence, Intensive Care Units, International Classification of Diseases, Lactates, Male, Middle Aged, Multiple Organ Failure, Organ Dysfunction Scores, Peer Review, Prospective Studies, Research, Respiratory Rate, Sensitivity and Specificity, Sepsis, Septic, Severity of Illness Index, Shock, Systemic Inflammatory Response Syndrome, Terminology as Topic, Time Factors, Vasoconstrictor Agents

 

Associated Logical Observation Identifiers Names and Codes [LOINC]
 

Parameter	LOINC's and Suggested Units
PaO2	11556-8 : mmHg      2703-7 : mmHg      19254-2 : mmHg
FIO2	3150-0 : %      19993-5 : %      19992-7 : %      19994-3 : %      19996-8 : %      19995-0 : %
Platelets	777-3 : x10^9/L      26515-7 : x10(3)/mcL
Total Bilirubin	1975-2 : mg/dL      32303-0 : mmol/L      59828-4 : mg/dL      54363-7 : mcmol/L      58941-6 : mg/dL
Glasgow Coma Score	9269-2 : score
Creatinine	2160-0 : mg/dL      38483-4 : mg/dL      14682-9 : mcmol/L      22726-4 : mcmol/L      59826-8 : mcmol/L
Urine Output	3167-4 : mL/day      9192-6 : mL/day
SOFA Score	96790-1 : score

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.