This page uses content from Wikipedia and is licensed under CC BY-SA.
Sepsis-related organ failure assessment score, also known as sequential organ failure assessment score (SOFA score), is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
The score tables below only describe points-giving conditions. In cases where the physiological parameters do not match any row, zero points are given. In cases where the physiological parameters match more than one row, the row with most points is picked.
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced.
qSOFA has also been found to be poorly sensitive though decently specific for the risk of death with SIRS possibly better for screening.
|PaO2/FiO2 (mmHg)||SOFA score|
|< 200 and mechanically ventilated||+3|
|< 100 and mechanically ventilated||+4|
|Glasgow coma scale||SOFA score|
|Mean arterial pressure OR administration of vasopressors required||SOFA score|
|MAP ≥ 70 mm/Hg||0|
|MAP < 70 mm/Hg||+1|
|dopamine ≤ 5 µg/kg/min or dobutamine (any dose)||+2|
|dopamine > 5 µg/kg/min OR epinephrine ≤ 0.1 µg/kg/min OR norepinephrine ≤ 0.1 µg/kg/min||+3|
|dopamine > 15 µg/kg/min OR epinephrine > 0.1 µg/kg/min OR norepinephrine > 0.1 µg/kg/min||+4|
|Bilirubin (mg/dl) [μmol/L]||SOFA score|
|< 1.2 [< 20]||0|
|> 12.0 [> 204]||+4|
|Creatinine (mg/dl) [μmol/L] (or urine output)||SOFA score|
|< 1.2 [< 110]||0|
|3.5–4.9 [300-440] (or < 500 ml/d)||+3|
|> 5.0 [> 440] (or < 200 ml/d)||+4|
The Quick SOFA Score (quickSOFA or qSOFA) was introduced by the Sepsis-3 group in February 2016 as a simplified version of the SOFA Score as an initial way to identify patients at high risk for poor outcome with an infection. The SIRS Criteria definitions of sepsis are being replaced as they were found to possess too many limitations; the “current use of 2 or more SIRS criteria to identify sepsis was unanimously considered by the task force to be unhelpful.” The qSOFA simplifies the SOFA score drastically by only including its 3 clinical criteria and by including "any altered mentation" instead of requiring a GCS ≤13. qSOFA can easily and quickly be repeated serially on patients.
|Low blood pressure (SBP ≤ 100 mmHg)||1|
|High respiratory rate (≥ 22 breaths/min)||1|
|Altered mentation (GCS <=13)||1|
The score ranges from 0 to 3 points. The presence of 2 or more qSOFA points near the onset of infection was associated with a greater risk of death or prolonged intensive care unit stay. These are outcomes that are more common in infected patients who may be septic than those with uncomplicated infection. Based upon these findings, the Third International Consensus Definitions for Sepsis recommends qSOFA as a simple prompt to identify infected patients outside the ICU who are likely to be septic.