Anaesthesia / Critical Care Emergency Medicine Strong — core component of Sepsis-3 definition; endorsed by SCCM/ESICM

Sequential Organ Failure Assessment (SOFA) Score

Quantifies degree of organ failure in ICU patients across 6 organ systems. Used for sepsis definition (Sepsis-3) and predicts ICU mortality. Scores each system 0–4.

Used in: Sepsis

Respiration — PaO₂/FiO₂ (P/F ratio)*

Coagulation — Platelet Count*

Liver — Bilirubin*

Cardiovascular — Mean Arterial Pressure / Vasopressors*

Neurological — GCS*

Renal — Creatinine or Urine Output*

Score interpretation

SOFA 0–1 — Minimal Organ Dysfunction (~1% ICU mortality) 0–1

SOFA 0–1: Minimal organ failure. ICU mortality ~1%.

→ Standard ICU monitoring. Treat underlying cause. Daily SOFA reassessment.

SOFA 2–3 — Mild Dysfunction (~6% ICU mortality) 2–3

SOFA 2–3: Mild organ dysfunction. ~6% ICU mortality. Note: SOFA ≥ 2 = organ dysfunction in Sepsis-3 definition.

→ Sepsis-3: if suspected infection + SOFA ≥ 2 from baseline → sepsis diagnosed. Blood cultures, IV antibiotics within 1h, IV fluids, lactate.

SOFA 4–6 — Moderate Dysfunction (~20% ICU mortality) 4–6

SOFA 4–6: Moderate multi-organ dysfunction. ~20% ICU mortality.

→ Intensive monitoring. Organ-specific support (vasopressors, ventilatory support, RRT). Daily reassessment. Goal-directed therapy.

SOFA 7–9 — Severe Dysfunction (~33% ICU mortality) 7–9

SOFA 7–9: Severe multi-organ dysfunction.

→ ICU escalation. Multidisciplinary team review. Goals-of-care discussion. Consider organ support limitations.

SOFA 10–14 — Very Severe (~50% ICU mortality) 10–14

SOFA 10–14: Very severe organ failure. ~50% ICU mortality.

→ Maximal supportive care. Early goals-of-care and DNACPR discussion with family. Palliative care involvement if appropriate.

SOFA ≥ 15 — Critical (>90% ICU mortality) 15–24

SOFA ≥ 15: Critical multi-organ failure. ICU mortality >90%.

→ Palliative care strongly indicated in most cases. Goals-of-care mandatory discussion. Comfort-focused care if elected.

Interpretation bands for the SOFA. Apply clinical judgement and local guidance.

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.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

Related