Interpretation
| Result | Meaning |
|---|---|
| 0–1 | Minimal organ dysfunction |
| ≥ 2 | Organ dysfunction; an acute rise of ≥2 points is the Sepsis-3 marker (originally defined with SOFA-1) |
| Higher | Mortality rises progressively with total score |
Formula
Brain: GCS 15 0 · 13–14 (or delirium drugs) 1 · 9–12 2 · 6–8 3 · 3–5 4. Respiratory P/F: >300 0 · ≤300 1 · ≤225 2 · ≤150 + advanced support 3 · ≤75 + advanced support or ECMO 4 (S/F if no PaO₂ and SpO₂ <98%: >300 0, ≤300 1, ≤250 2, ≤200 + support 3, ≤120 + support 4). Cardiovascular: MAP ≥70 no drugs 0 · MAP <70 1 · NE+Epi ≤0.2 or any other agent 2 · NE+Epi >0.2–0.4, or ≤0.2 + other agent 3 · NE+Epi >0.4, or >0.2–0.4 + other agent, or mechanical support 4 (dopamine alone ≤20/≤40/>40 µg/kg/min = 2/3/4). Liver bilirubin (mg/dL): ≤1.2 0 · ≤3.0 1 · ≤6.0 2 · ≤12 3 · >12 4. Kidney creatinine (mg/dL): ≤1.2 0 · ≤2.0 or UO <0.5 mL/kg/h 6–12 h 1 · ≤3.5 or UO <0.5 ≥12 h 2 · >3.5 or UO <0.3 ≥24 h or anuria ≥12 h 3 · RRT (or meets criteria) 4. Platelets (×10³/µL): >150 0 · ≤150 1 · ≤100 2 · ≤80 3 · ≤50 4.
Clinical pearls
- Without advanced respiratory support the respiratory score is capped at 2, unless support is unavailable or limited by a ceiling of care. ECMO for respiratory failure scores 4 respiratory only; ECMO for cardiac indications scores 4 in both cardiovascular and respiratory (tick mechanical support and ECMO).
- Vasopressors count only if infused continuously for ≥1 hour; norepinephrine is dosed as the base (1 mg base = 2 mg bitartrate monohydrate).
- Missing values on day 1 score 0. For sedated patients use the last GCS before sedation (0 if unknown).
Examples
sofa-2 gcs 15 pao2 80 fio2 50% on hfnc map 65 norepi 0.1 bili 2.5 cr 2.2 plt 80SOFA 2 score: intubated, SpO2 90% on FiO2 0.6, GCS 7, norepinephrine 0.3 plus vasopressin, bilirubin 1.0, creatinine 1.0 with urine output under 0.5 mL/kg/h for 14 hours, platelets 151sofa2 all normal gcs 15 pao2 95 room air map 75 bili 0.8 creat 0.9 plt 200
FAQ
What changed from SOFA to SOFA-2?
SOFA-2 renames coagulation as hemostasis with new platelet cut-offs (150/100/80/50), adds delirium treatment to the brain score, requires advanced respiratory support for 3–4 respiratory points and counts ECMO, scores norepinephrine plus epinephrine together with mechanical support, and adds urine-output and RRT criteria to the kidney score.
Can SpO₂/FiO₂ be used in SOFA-2?
Yes, when PaO₂ is unavailable and SpO₂ is below 98%, using cut-offs of 300, 250, 200 (with support) and 120 (with support).