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SOFA score (Sequential Organ Failure Assessment)

Also called SOFA, Sepsis-related Organ Failure Assessment, organ dysfunction score

Six-organ dysfunction score (0–24); an acute rise of 2 or more with infection defines sepsis (Sepsis-3).

Respiration: PaO₂/FiO₂, mmHg
Coagulation: platelets ×10³/µL
Liver: bilirubin mg/dL (µmol/L)
Cardiovascular (catecholamines µg/kg/min for ≥ 1 h)
CNS: Glasgow Coma Scale
Renal: creatinine mg/dL (µmol/L) or urine output – take the worse

Assume 0 if no known pre-existing organ dysfunction.

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Formula and scoring

Sum of six organ scores (0–4 each): respiration, coagulation, liver, cardiovascular, CNS, renal. Thresholds as in Sepsis-3 Table 1 (adapted from Vincent 1996).

Exam and ward pearls

  • Septic shock (Sepsis-3) = vasopressor needed to keep MAP ≥ 65 mmHg and lactate > 2 mmol/L despite adequate fluids.

When not to rely on it

  • Respiratory scores 3–4 require respiratory support. SOFA was built to describe organ dysfunction, not as a stand-alone mortality model.

Source

  1. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-10. doi:10.1007/BF01709751 · PMID 8844239
  2. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-10. doi:10.1001/jama.2016.0287 · PMID 26903338

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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