SOFA Score

Interpretation

Mortality estimates are approximate and derived from original SOFA validation cohorts. The score should be interpreted in clinical context alongside patient trajectory.

Clinical Application

• Sepsis-3 definition (2016): Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Operationalised as an acute rise in SOFA score ≥ 2 points from baseline in the setting of a suspected infection.
• Septic shock: Defined as sepsis plus vasopressor requirement to maintain MAP ≥ 65 mmHg AND lactate > 2 mmol/L despite adequate fluid resuscitation. ICU mortality >40%.
• Serial SOFA scoring is more prognostically valuable than a single measurement. Rising SOFA correlates with worsening prognosis; improving SOFA correlates with recovery. Use to track response to ICU treatment.
• qSOFA as pre-ICU screen: qSOFA (≥2 of: RR≥22, GCS<15, SBP≤100) identifies ward patients at high risk who should be assessed for organ dysfunction with full SOFA.
• The cardiovascular component grades vasopressor dose in μg/kg/min — document these values precisely in ICU handover.
• When ABG is unavailable, SpO₂/FiO₂ (S/F ratio) can substitute for PaO₂/FiO₂: S/F of ~235 approximates P/F 200, and S/F ~315 approximates P/F 300 (use with caution).

References

1. 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.
2. Singer M, et al. (Sepsis-3). The Third International Consensus Definitions for Sepsis and Septic Shock. JAMA. 2016;315(8):801–810.
3. Ferreira FL, et al. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754–1758.

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