What is the SOFA score?
The SOFA (Sequential Organ Failure Assessment) measures the degree of organ dysfunction in the critically ill patient, evaluating six systems: respiratory, coagulation, liver, cardiovascular, central nervous system, and kidneys. Each system receives a score from 0 to 4, for a total of 0 to 24: the higher the score, the greater the severity and expected mortality. It is central to the definition of sepsis (Sepsis-3), where sepsis corresponds to a SOFA increase ≥ 2 points from suspected infection.
SOFA table by organ system
| System | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Respiratory — PaO₂/FiO₂ (mmHg) | ≥400 | <400 | <300 | <200* | <100* |
| Coagulation — Platelets (×10³/µL) | ≥150 | <150 | <100 | <50 | <20 |
| Liver — Bilirubin (mg/dL) | <1.2 | 1.2–1.9 | 2.0–5.9 | 6.0–11.9 | ≥12 |
| Cardiovascular | MAP ≥70 | MAP <70 | Dopa ≤5 or Dobu | Dopa >5 / Epi ≤0.1 / Nor ≤0.1 | Dopa >15 / Epi >0.1 / Nor >0.1 |
| CNS — Glasgow Coma Scale | 15 | 13–14 | 10–12 | 6–9 | <6 |
| Kidneys — Creatinine (mg/dL) | <1.2 | 1.2–1.9 | 2.0–3.4 | 3.5–4.9 | ≥5.0 |
The numbers in the header are the points assigned. * with respiratory support (ventilation). Vasopressor doses in µg/kg/min. MAP = mean arterial pressure.
Correlation with mortality
In-hospital mortality rises with the total score (indicative values):
- SOFA 0–6mortality < 10%
- SOFA 7–9mortality 15–20%
- SOFA 10–12mortality 40–50%
- SOFA 13–14mortality 50–60%
- SOFA ≥15mortality > 80%
qSOFA: rapid sepsis screening
The qSOFA (quick SOFA) is a bedside screening tool, without laboratory tests, to early identify patients at risk of sepsis outside the ICU. It is based on three criteria (1 point each):
- Respiratory rate ≥ 22 breaths/min
- Systolic blood pressure ≤ 100 mmHg
- Altered mental status (GCS < 15)
A qSOFA ≥ 2 identifies patients with worse prognosis, who should be assessed urgently and considered for a full SOFA calculation.
Source: Vincent JL, et al. The SOFA score. Intensive Care Med. 1996; Singer M, et al. Sepsis-3. JAMA. 2016. This tool is for educational and support purposes: it does not replace clinical judgment or local protocols.