Modified SOFA Score of Vincent et al

Description

The Sepsis-related Organ Failure Assessment (SOFA) score is a score for evaluating multiorgan failure in intensive care patients with the sepsis syndrome.

Differences from the original SOFA score: removal of Glasgow coma score (CNS status); removal of urine output

Parameters:

(1) PaO2 to FIO2 ratio

(2) platelet count per microliter

(3) serum total bilirubin in mg/dL

(4) hypotension

(5) serum creatinine in mg/dL

Measure	Finding	Points
PaO2 to FIO2 ratio	>= 400 mm Hg	0
	300 – 399 mm Hg	1
	200 – 299 mm Hg	2
	100 – 199 mm Hg with respiratory support	3
	< 100 mm Hg with respiratory support	4
platelet count	>= 150,000 per µL	0
	100,000 to 149,999 per µL	1
	50,000 to 99,999 per µL	2
	20,000 to 49,999 per µL	3
	< 20,000 per µL	4
serum bilirubin	< 1.2 mg/dL	0
	1.2 – 1.9 mg/dL	1
	2.0 – 5.9 mg/dL	2
	6.0 – 11.9 mg/dL	3
	>= 12.0 mg/dL	4
hypotension	mean arterial pressure >= 70 mm Hg, without vasopressors	0
	mean arterial pressure < 70 mm Hg, without vasopressors	1
	dobutamine, any dose	2
	dopamine <= 5 µg per kg per min	2
	dopamine > 5 to 15 µg per kg per min	3
	dopamine > 15 µg per kg per min	4
	epinephrine <= 0.1 µg per kg per min	3
	epinephrine > 0.1 µg per kg per min	4
	norepinephrine <= 0.1 µg per kg per min	3
	norepinephrine > 0.1 µg per kg per min	4
serum creatinine	serum creatinine < 1.2 mg/dL	0
	serum creatinine 1.2 – 1.9 mg/dL	1
	serum creatinine 2.0 – 3.4 mg/dL	2
	serum creatinine 3.5 – 4.9 mg/dL	3
	serum creatinine >= 5.0 mg/dL	4

where:

• PaO2 is in mm Hg and FIO2 in percent from 0.21 to 1.00.

• Adrenergic agents as administered for at least 1 hour with doses in µg per kg per min.

• A score of 0 indicates normal and a score of 4 indicates most abnormal.

• Data can be collected and the score calculated daily during the course of the admission.

mean systemic arterial pressure in mm Hg =

= ((systolic systemic arterial pressure in mm Hg) + (2 * (diastolic systemic arterial pressure in mm Hg))) / 3

Arnold et a used SpO2 to FIO2 ratio instead of the PaO2 to FIO2 ratio and did not specify respiratory support.

SpO2 to FIO2 ratio	>= 302	0
	221 to 301	1
	140 to 220	2
	67 to 141	3
	< 67	4

modified SOFA score =

= SUM(points for all 5 measures)

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the organ score, the greater the organ dysfunction.

• The higher the total score, the greater the multiorgan dysfunction.

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Modified SOFA Score of Vincent et al

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