SOFA Score
Quantifies organ dysfunction in ICU/HDU; sequential increase ≥2 defines sepsis
How to use & interpret
The SOFA score quantifies organ dysfunction across six systems (respiratory, coagulation, liver, cardiovascular, central nervous system and renal), each scored 0–4. It underpins the Sepsis-3 definition: sepsis is suspected or confirmed infection with an acute rise in SOFA of ≥2 points.
It is primarily an intensive-care tool for tracking organ dysfunction and prognosis over time. For rapid screening outside critical care, qSOFA or (in the UK) NEWS2 is used instead.
Score interpretation
Initial SOFA 0–1: 0% ICU mortality (Ferreira 2001).
→ Monitor; treat the underlying cause. Sepsis-3: an acute rise of 2 or more points with infection defines sepsis.
Initial SOFA 2–3: 6.4% ICU mortality (Ferreira 2001).
→ Monitor; treat the underlying cause. Sepsis-3: an acute rise of 2 or more points with infection defines sepsis.
Initial SOFA 4–5: 20.2%; 6–7: 21.5% ICU mortality (Ferreira 2001).
→ HDU/ICU monitoring; organ support as needed.
Initial SOFA 8–9: 33.3% ICU mortality (Ferreira 2001).
→ ICU review; organ support as needed.
Initial SOFA 10–11: 50% ICU mortality (Ferreira 2001).
→ Full organ support; ICU escalation.
Initial SOFA above 11: mortality above 90% (95.2%, Ferreira 2001).
→ Maximal organ support; senior critical care input; goals-of-care discussion.
Interpretation bands for the SOFA. Apply clinical judgement and local guidance.
Frequently asked questions
What is the difference between SOFA and qSOFA?
SOFA is a detailed organ-dysfunction score needing laboratory values, used mainly in ICU; qSOFA is a 3-item bedside prompt to raise suspicion of sepsis outside ICU.
References
- Vincent JL, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707–10.
Related
Curated clinical cross-links plus same-class fallbacks.
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The SOFA is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.