The original Sequential Organ Function Assessment (SOFA) score measured respiratory function using PaO2, which requires an arterial blood gas. Using the oxygen saturation from a pulse oximeter is much more convenient, especially in a resource-poor facility. Sendagire et al demonstrated the use of this modified score.
Parameters:
(1) SpO2 to FIO2 ratio (replaces the PaO2 to FIO2 ratio)
(2) platelet count per µL, as a measure of coagulation
(3) total serum bilirubin in mg/dL, as a measure of hepatic function
(4) hypotension, as a measure of cardiovascular function
(5) Glasgow coma score (GCS), as measure of neurologic function
(6) serum creatinine in mg/dL and urine output in mL/day as measures of renal function
|
Measure |
Finding |
Points |
|
SpO2 to FIO2 ratio |
> 301 mm Hg |
0 |
|
|
221 – 301 mm Hg |
1 |
|
|
142 – 220 mm Hg |
2 |
|
|
67 – 141 mm Hg |
3 |
|
|
< 67 mm Hg |
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 |
0 |
|
|
mean arterial pressure < 70 mm Hg, no pressor agents used |
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 |
|
Glasgow coma score |
15 |
0 |
|
|
13 - 14 |
1 |
|
|
10 - 12 |
2 |
|
|
6 - 9 |
3 |
|
|
3 - 5 |
4 |
|
serum creatinine or urine output |
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 |
|
|
urine output 200 - 499 mL per day |
3 |
|
|
serum creatinine >= 5.0 mg/dL |
4 |
|
|
urine output < 200 mL per day |
4 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the more severe the patient's condition.
Specialty: Critical Care, Infectious Diseases
