Background
The development of the SOFA score
Calculation of the SOFA score standard approach
Respiratory system | |
PaO2/FiO2 (mmHg) | SOFA score |
> 400 | 0 |
< 400 | 1 |
< 300 | 2 |
< 200 with respiratory support | 3 |
< 100 with respiratory support | 4 |
Nervous system | |
Glasgow Coma Scale | SOFA score |
15 | 0 |
13–14 | 1 |
10–12 | 2 |
6–9 | 3 |
< 6 | 4 |
Cardiovascular system | |
Mean arterial pressure (MAP) OR administration of vasopressors required | SOFA score |
MAP > 70 mmHg | 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 μh/kg/min OR epinephrine > 0.1 μg/kg/min OR norepinephrine > 0.1 μg/kg/min | 4 |
Liver | |
Bilirubin (mg/dl) [μmol/L] | SOFA score |
< 1.2 (< 20) | 0 |
1.2–1.9 [20–32] | 1 |
2.0–5.9 [33–101] | 2 |
6.0–11.9 [102–204] | 3 |
> 12.0 [> 204] | 4 |
Coagulation | |
Platelets ×103/ml | SOFA score |
> 150 | 0 |
< 150 | 1 |
< 100 | 2 |
< 50 | 3 |
< 20 | 4 |
Kidneys | |
Creatinine (mg/dl) [μmol/L]; urine output | SOFA score |
< 1.2 [< 110] | 0 |
1.2–1.9 [110–170] | 1 |
2.0–3.4 [171–299] | 2 |
3.5–4.9 [300–440] (or urine output < 500 ml/day) | 3 |
> 5.0 [> 440]; urine output < 200 ml/day | 4 |
SOFA score terminology
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Admission SOFA: The admission SOFA score is calculated based on the most severe value for each sub-score in the 24 h preceding admission to ICU [9].
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Daily Maximum SOFA score: The daily maximum SOFA score is equivalent to the daily SOFA score as when calculated for each 24 h assessment; the most severe value of each sub-score for that time period should be calculated in the assessment of the SOFA score.
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Maximum SOFA score: The maximum SOFA score describes the highest daily SOFA score over the course of the study period.
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Delta SOFA score: The delta SOFA is calculated as the change in total SOFA score (or that of an individual sub-score) between a defined time point and the baseline value. The baseline value may be the admission SOFA or a defined study day.
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Mean SOFA: The mean SOFA score is calculated for an individual patient over the course of a defined study period based on the total SOFA score for each study day.
Generic rules for measuring components of the SOFA score
Selecting the daily value
Handling missing data
The central nervous system (CNS) SOFA component
The respiratory SOFA component
Estimated FiO2 in patients supported with low flow nasal cannula | ||||||||
---|---|---|---|---|---|---|---|---|
Flow rate (l/min) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Estimated FiO2 | 0.24 | 0.27 | 0.3 | 0.33 | 0.36 | 0.39 | 0.42 | 0.45 |
Estimated FiO2 in patients supported with oxygen via facemask | Estimated FiO2 in patients supported with oxygen via facemask with reservoir bag | ||||||||
---|---|---|---|---|---|---|---|---|---|
Flow rate (l/min) | 5 | 6–7 | 7–8 | Flow rate (l/min) | 6 | 7 | 8 | 9 | 10+ |
Estimated FiO2 | 0.4 | 0.5 | 0.6 | Estimated FiO2 | 0.6 | 0.7 | 0.8 | 0.9 | 0.95 |
The cardiovascular (CVS) SOFA component
Drug | Dose | Norepinephrine equivalent |
---|---|---|
Epinephrine | 0.1 μg/kg/min | 0.1 μg/kg/min |
Norepinephrine | 0.1 μg/kg/min | 0.1 μg/kg/min |
Dopamine | 15 μg/kg/min | 0.1 μg/kg/min |
Phenylephrine | 1.0 μg/kg/min | 0.1 μg/kg/min |
Vasopressin | 0.04 U/min | 0.1 μg/kg/min |