Sequential Organ Failure Assessment
Use when asked to administer, score, or explain the Sequential Organ Failure Assessment (SOFA) — six organ-system sub-scores (0-4 each) summing to a 0-24 total, tracked as delta-SOFA and used in Sepsis-3 criteria — grounded in FormExamples/form-examples; the definitive counterpart to quick-sequential-organ-failure-assessment.
A UK NHS-aligned, clinician-driven SOFA score that records objective physiological and laboratory findings for six organ systems and computes an organ-dysfunction score for each system (0–4), a total SOFA score (0–24), the change from a prior assessment (delta-SOFA), a mortality-risk band, and safety-critical flags. The output is a signed clinician report suitable for the intensive-care record and for sepsis screening under the Sepsis-3 definition.
Developed by the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine (Vincent et al., Intensive Care Medicine 1996) to describe and quantify organ dysfunction over time in critically ill patients. Under Sepsis-3 (Singer et al., JAMA 2016), an acute rise in total SOFA of ≥ 2 points in a patient with suspected infection identifies sepsis.
Scoring
Six organ systems, each scored 0–4 on objective criteria: respiration (PaO₂/FiO₂ ratio), coagulation (platelet count), liver (bilirubin), cardiovascular (mean arterial pressure and vasopressor dose), central nervous system (Glasgow Coma Scale), and renal (creatinine and urine output). Total 0–24. Delta-SOFA — the change from a recorded baseline — is itself clinically significant: a rising score over the first 48 hours of ICU admission predicts at least 50% mortality regardless of the initial score. Sepsis-3 flag — an acute increase of ≥ 2 points from baseline in a patient with suspected infection.
What it covers
Clinician and context; patient and baseline (including prior SOFA for delta calculation); respiration; coagulation; liver; cardiovascular; central nervous system; renal; and a summary with per-system sub- scores, total, delta-SOFA, mortality band, Sepsis-3 flag, and sign-off.
Relationship to quick-sequential-organ-failure-assessment
Quick Sequential Organ Failure Assessment (qSOFA) is the simplified, lab-free bedside screen usable anywhere, including outside the ICU; this full SOFA score is the definitive instrument requiring laboratory and physiological data, appropriate for ICU/HDU use once a positive qSOFA screen (or other clinical concern) prompts it.
Common pitfalls
- Scoring SOFA without a recorded baseline — delta-SOFA (the clinically meaningful trend) requires a baseline; without one, assume baseline SOFA is 0 only when there's genuinely no known pre-existing organ dysfunction, not by default.
- Treating a single SOFA score as sufficient — the trend over the first 48 hours carries independent prognostic value beyond any single reading; repeat scoring, not a one-off, is the point.
- Using qSOFA and full SOFA interchangeably — see Quick Sequential Organ Failure Assessment; they have different data requirements, different scoring ranges, and different intended settings.
Learn more
- Vincent J.L. et al. The SOFA (Sepsis-related Organ Failure Assessment) score. Intensive Care Medicine 1996; 22:707–10.
- FormExamples: sequential-organ-failure-assessment for the full implementation and clinical references.
- Quick Sequential Organ Failure Assessment for the simplified bedside screening counterpart.