Organ dysfunction assessment
Sequential Organ Failure Assessment (SOFA)
Input laboratory and clinical parameters to compute the SOFA score (0–24). Track daily to monitor disease trajectory in sepsis, shock, or ICU patients.
Required for respiratory score ≥3.
<500 mL → score ≥3, <200 mL → score 4.
PaO₂/FiO₂ ratio
160
mmHg
Total SOFA
13
Resp 3 • Coag 1 • Liver 1
Cardio 3 • CNS 2 • Renal 3
SOFA ≥11 corresponds to substantial organ failure and high ICU mortality. Immediate advanced critical care required.
A rise of ≥2 points from baseline is consistent with Sepsis-3 organ dysfunction.
How to Use This Calculator
Collect worst values in the past 24 hours
SOFA uses the most abnormal measurements. Document the time period for reproducibility.
Categorize vasopressor doses accurately
Record doses in µg/kg/min. Convert when necessary (e.g., µg/min ÷ weight).
Trend SOFA daily
Improving scores predict better outcomes. Rising scores signal deterioration and need for escalation.
Scoring Table
- Respiratory: PaO₂/FiO₂ ≥400 (0), <400 (1), <300 (2), <200 + ventilation (3), <100 + ventilation (4).
- Coagulation: Platelets ≥150 (0), 100–149 (1), 50–99 (2), 20–49 (3), <20 (4).
- Liver: Bilirubin <1.2 (0), 1.2–1.9 (1), 2.0–5.9 (2), 6.0–11.9 (3), ≥12 (4).
- Cardiovascular: MAP ≥70 (0); MAP <70 (1); Dopamine ≤5 or Dobutamine any (2); Dopamine 5.1–15 or Norepi/Epi ≤0.1 (3); Dopamine >15 or Norepi/Epi >0.1 (4).
- CNS: GCS 15 (0), 13–14 (1), 10–12 (2), 6–9 (3), <6 (4).
- Renal: Creatinine <1.2 (0), 1.2–1.9 (1), 2.0–3.4 (2), 3.5–4.9 or urine <500 mL (3), ≥5.0 or urine <200 mL (4).
Full Description
The SOFA score quantifies organ failure across six systems. It is widely used in sepsis bundles, ICU triage, and research stratification. In Sepsis-3, an increase of ≥2 points from baseline identifies sepsis. Persistent high scores correlate with mortality, while decreasing scores suggest recovery.
Limitations: sedation may artificially lower GCS; bilirubin lags behind acute hepatic injury; chronic organ dysfunction can elevate baseline scores. Always interpret alongside clinical judgement, laboratory trends, and imaging.
Frequently Asked Questions
How do I score patients on chronic dialysis?
Use pre-dialysis creatinine if available or urine output criteria. Consider baseline renal replacement when interpreting trends.
What if PaO₂ is unavailable?
Estimate from SpO₂/FiO₂ if necessary, but note reduced accuracy. Obtain arterial blood gas if clinically important.
Does SOFA apply to pediatric patients?
Pediatric SOFA (pSOFA) uses age-adjusted thresholds. Do not directly apply adult SOFA to children.
How often should SOFA be calculated?
Daily assessment is standard in the ICU. Recalculate after major clinical changes (e.g., post-op, shock episodes).