From the Guidelines
The SOFA (Sequential Organ Failure Assessment) scale describes the degree of organ failure in critically ill patients, particularly those with sepsis-associated multiple organ failure or dysfunction in critical care units.
Key Components of the SOFA Scale
- The score is based on 6 different organ systems:
- Respiratory
- Cardiovascular
- Hepatic
- Coagulation
- Renal
- Neurological
- It does not include age and chronic health or comorbidities 1
Clinical Application of the SOFA Scale
- The SOFA score is used to assess the severity of illness and predict outcomes in critically ill patients 1
- It can be used to track the time course of a patient's condition during their ICU stay and monitor disease progression 1
- A high SOFA score is associated with increased mortality, with a score > 10 predictive of mortality in 93% of cases 1
Limitations of the SOFA Scale
- The SOFA scale was not designed to categorize patients with low-moderate severity without sepsis or organ failure within 24 hours of hospital admission 1
- It does not take into account age and chronic health or comorbidities, which are important components of other severity scoring systems like APACHE II 1
From the Research
Overview of the SOFA Scale
- The SOFA (Sequential Organ Failure Assessment) scale is a tool used to assess the acute morbidity of critical illness at a population level 2.
- It has been widely validated as a tool for this purpose across a range of healthcare settings and environments 2.
- The SOFA score is used to evaluate, prognosticate, and assess patients in the Intensive Care Unit (ICU) 3.
Applications of the SOFA Scale
- The SOFA score has been used in various settings, including medical, trauma, surgical, cardiac, and neurological ICUs 3.
- It has been used as a predictor of outcome in sepsis in pediatric intensive care units 4.
- The SOFA score is also used to assess the severity of illness and to detect organ failure in critically ill patients 5.
Components of the SOFA Scale
- The SOFA score includes components for respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems 3, 5.
- Each component score is used to assess the severity of organ dysfunction in each system 3, 5.
- The accuracy of the SOFA score can be affected by factors such as sedation, which can preclude neurological evaluation 5.
Limitations and Future Directions
- The SOFA score has some limitations, including the need for a simpler neurological classification tool than the Glasgow Coma Scale 5.
- There is a need to update the SOFA score to reflect changes in clinical practice and new interventions 6.
- Proposed updates to the SOFA score include the inclusion of new variables to improve its accuracy and validity 6.