Calculate the Sequential Organ Failure Assessment (SOFA) score daily in ICU patients to quantify organ dysfunction across respiratory, coagulation, hepatic, cardiovascular, neurological, and renal systems.
The SOFA score tracks the degree of organ dysfunction across six systems in ICU patients — respiratory, coagulation, liver, cardiovascular, CNS, and renal. Each system is scored 0–4 and the six sub-scores sum to a total of 0–24. Use the worst (most deranged) value recorded for each variable within the assessment window, typically the first 24 hours of admission or the current 24-hour period.
Gathering each input: Respiratory uses the PaO₂/FiO₂ ratio (mmHg) and whether the patient is mechanically ventilated. Coagulation uses the platelet count (×10³/µL). Liver uses serum bilirubin (mg/dL). Cardiovascular uses mean arterial pressure (MAP, mmHg) and vasopressor dosing — record the highest vasopressor requirement. CNS uses the Glasgow Coma Scale (3–15). Renal uses serum creatinine (mg/dL) and, when available, 24h urine output (mL).
Interpreting the result: A sub-score of 2 or more in any system indicates organ dysfunction, and the total rises with the number and severity of failing systems. Higher totals carry progressively higher mortality risk — scores of 8 or more are associated with high mortality. Use the score to track the trajectory of organ failure over time and to stratify patients — not as the sole basis for individual treatment decisions.