From the Guidelines
The SOFA score is a medical scoring system used to track a patient's status during critical illness, evaluating six organ systems and assigning a score from 0 to 4, with a total score ranging from 0 to 24, and is valuable for predicting outcomes in sepsis patients and guiding patient care and resource allocation 1.
Overview of the SOFA Score
The SOFA score is a widely used scoring system in intensive care units to assess the severity of organ dysfunction in critically ill patients. It evaluates six organ systems: respiratory, cardiovascular, hepatic, coagulation, renal, and neurological, assigning each a score from 0 (normal) to 4 (severe dysfunction) 1.
Calculation of the SOFA Score
The total SOFA score ranges from 0 to 24, with higher scores indicating more severe organ dysfunction and a higher risk of mortality. The score is calculated daily to monitor disease progression and response to treatment 1.
Clinical Application of the SOFA Score
The SOFA score is particularly useful for predicting outcomes in sepsis patients, where a change in SOFA score of 2 or more points indicates organ dysfunction 1. It provides an objective measure of multiple organ systems simultaneously, helping clinicians make informed decisions about patient care and resource allocation.
Key Points
- The SOFA score evaluates six organ systems: respiratory, cardiovascular, hepatic, coagulation, renal, and neurological 1.
- The total SOFA score ranges from 0 to 24, with higher scores indicating more severe organ dysfunction and a higher risk of mortality 1.
- The SOFA score is valuable for predicting outcomes in sepsis patients and guiding patient care and resource allocation 1.
- A change in SOFA score of 2 or more points indicates organ dysfunction in sepsis patients 1.
From the Research
Definition and Purpose of the SOFA Score
- The Sequential Organ Failure Assessment (SOFA) score is a system used in Intensive Care Units (ICUs) to evaluate, prognosticate, and assess patients 2.
- The SOFA score serves as a strong mortality predictor and has been used to distinguish survivors from non-survivors on admission 2, 3.
Components and Modifications of the SOFA Score
- The SOFA score assesses multiple organ systems, including respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems 2.
- Over the years, various modifications have been proposed to the SOFA score, leading to the evolution of alternate validated scoring models 2.
- Examples of modified SOFA scores include the quick SOFA, Lactic acid quick SOFA (LqSOFA), and SOFA scores specific to certain clinical populations, such as patients with cardiac dysfunction or hepatic failure 2.
Clinical Applications and Predictive Value of the SOFA Score
- The SOFA score has been used to predict mortality in critically ill patients, including those with acute kidney injury undergoing continuous renal replacement therapy 4, 5.
- Studies have shown that the SOFA score is superior to other scoring systems, such as the APACHE-II score, in predicting the prognosis of certain patient populations 5.
- The SOFA score has been found to be a simple yet effective method for describing organ dysfunction and failure in critically ill patients, enabling comparison between patients and monitoring of disease development 3.
Limitations and Future Directions
- Despite its widespread use, the SOFA score may require updates to reflect changes in clinical practice and the introduction of new interventions and monitoring systems 6.
- Researchers have proposed the development of a new, validated SOFA score (SOFA 2.0) that incorporates new variables and is fit for modern practice 6.