The Sepsis-related Organ Failure Assessment (SOFA) score is a score for evaluating multiorgan failure in intensive care patients with the sepsis syndrome. Shime et al proposed a modification for use in children. The authors are from Hiroshima University, Shizuoka Children's Hospital and the National Centre for Child Health and Development in Japan.
Patient selection: <= 18 years of age
Differences from the original SOFA score:
(1) systolic arterial blood pressure rather than mean arterial
(2) use of age-dependent limits for systolic blood pressure and serum creatinine
(3) removal of urine output as a measure of renal function
(4) addition of respiratory support to respiratory function
(5) slight change to cut-offs for platelet count
Measure |
Finding |
Points |
PaO2 to FIO2 ratio |
>= 400 mm Hg |
0 |
|
300 – 399 mm Hg, oxygen therapy |
1 |
|
200 – 299 mm Hg, noninvasive support |
2 |
|
100 – 199 mm Hg, ventilatory support |
3 |
|
< 100 mm Hg, ventilatory support |
4 |
platelet count |
> 150,000 per µL |
0 |
|
100,001 to 150,000 per µL |
1 |
|
50,001 to 100,000 per µL |
2 |
|
20,001 to 50,000 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 |
systolic blood pressure >= aged-based cutoff |
0 |
|
systolic blood pressure < age-based cut-off, 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 |
< age-based cut-off |
0 |
|
1 to 1.6 times age-based cutoff |
1 |
|
1.7 to 2.8 times age-based cutoff |
2 |
|
2.9 to 4.1 times age-based cutoff |
3 |
|
>= 4.2 times age-based cutoff |
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.
Age |
Systolic BP in mm Hg |
< 1 week |
60 |
1 week to 1 month |
65 |
1 month to 1 year |
70 |
2-5 years |
75 |
6-12 years |
80 |
13-18 years |
90 |
Age |
Serum Creatinine in mg/dL |
< 1 week |
0.8 |
1 week to 1 month |
0.3 |
1 month to 1 year |
0.4 |
2-5 years |
0.6 |
6-12 years |
0.7 |
13-18 years |
1.0 |
total SOFA score =
= SUM(points for all 6 measures)
Interpretation:
• minimum total score: 0
• maximum total score: 24
• The higher the organ score, the greater the organ dysfunction.
• The higher the total score, the greater the multiorgan dysfunction.
Specialty: Emergency Medicine, Critical Care, Pulmonology, Infectious Diseases