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  Sequential Organ Failure Assessment: SOFA Score

 
Input
 
PaO2  
FIO2  
Ventilatory Support Yes (1)

No (0)
Platelets  
Total Bilirubin  
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  
Creatinine  
Urine Output  

 
Results
 
 
PaO2/FIO2  
SOFA 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 PubMed Logo
  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 PubMed Logo

 

 
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.

 
Associated ICD10-CM Codes
 
   J96.90Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia
   J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
   A41.9Sepsis, unspecified organism
   I50.9Heart failure, unspecified
   N19Unspecified kidney failure
   N17.9Acute kidney failure, unspecified

 
Associated ICD9-CM Codes
 
   584.9Acute renal failure nos
   586Renal failure nos
   428.9Heart failure nos
   038.9Septicemia nos
   518.81Acute respiratry failure

 
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