The Pediatric Sepsis-related Organ Failure Assessment (SOFA) Score

Description

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.

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The Pediatric Sepsis-related Organ Failure Assessment (SOFA) Score

Description

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