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 (0% mortality) 0–1

Initial SOFA 0–1: no deaths among 43 patients (Ferreira 2001).

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

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

Initial SOFA 2–3: mortality 6.5 % (Ferreira 2001). 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 4–5 — Moderate Dysfunction (~20% mortality) 4–5

Initial SOFA 4–5: mortality 20 % (Ferreira 2001).

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

SOFA 6–7 — Moderate Dysfunction (~22% mortality) 6–7

Initial SOFA 6–7: mortality 22 % (Ferreira 2001).

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

SOFA 8–9 — Severe Dysfunction (~33% mortality) 8–9

Initial SOFA 8–9: mortality 33 % (Ferreira 2001).

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

SOFA 10–11 — Very Severe (~50% mortality) 10–11

Initial SOFA 10–11: mortality 50 % (Ferreira 2001).

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

SOFA ≥ 12 — Critical (>90% mortality) 12–24

Initial SOFA > 11: mortality 95 % (Ferreira 2001).

→ 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.
Ferreira FL, et al. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754–1758.
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

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