SOFA Score Calculator

Calculate Sequential Organ Failure Assessment (SOFA) score for ICU patients. Part of the Sepsis-3 criteria for diagnosing sepsis.

Important Clinical Disclaimer: SOFA Score Calculator is intended for use by qualified healthcare professionals only. It is for educational and informational purposes and should not replace clinical judgement. Always interpret results alongside the full clinical picture and follow your local guidelines and protocols.
Respiration (PaO₂/FiO₂ ratio)
PaO₂/FiO₂ ratio (P/F ratio). Respiratory support = mechanical ventilation including CPAP.
Coagulation (Platelets)
Liver (Bilirubin)
Cardiovascular (Hypotension)
Vasopressor doses in μg/kg/min for at least 1 hour. MAP = Mean Arterial Pressure.
Central Nervous System (Glasgow Coma Scale)
Use GCS Calculator if needed. If sedated, estimate GCS before sedation.
Renal (Creatinine or Urine Output)
UO = Urine Output. Creatinine-based scoring preferred if available.
Sepsis Assessment (Optional)
For Sepsis-3 septic shock criteria assessment.
About SOFA Score
What is SOFA?

The Sequential Organ Failure Assessment (SOFA) score was developed in 1994 by the European Society of Intensive Care Medicine to describe the degree of organ dysfunction/failure in critically ill patients. Originally called the "Sepsis-related Organ Failure Assessment," it was renamed as it applies to all ICU patients regardless of infection status.

Sepsis-3 Definition (2016)

The Third International Consensus Definitions for Sepsis (Sepsis-3) incorporated SOFA into the definition of sepsis:

Sepsis: Life-threatening organ dysfunction caused by a dysregulated host response to infection, identified by an acute increase in SOFA score of ≥2 points.
Septic Shock: Sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥65 mmHg AND serum lactate >2 mmol/L despite adequate volume resuscitation.
Components

SOFA assesses six organ systems, each scored 0-4 based on degree of dysfunction:

  1. Respiration: PaO₂/FiO₂ ratio
  2. Coagulation: Platelet count
  3. Liver: Bilirubin level
  4. Cardiovascular: Mean arterial pressure and vasopressor requirements
  5. Central Nervous System: Glasgow Coma Scale
  6. Renal: Creatinine or urine output
SOFA Score and Mortality
SOFA Score ICU Mortality Interpretation
0-1 <5% Minimal organ dysfunction
2-3 ~10% Mild organ dysfunction
4-5 ~15% Moderate organ dysfunction
6-7 ~20% Moderate-severe dysfunction
8-9 ~35% Severe organ dysfunction
10-11 ~50% Very severe dysfunction
≥12 >80% Multi-organ failure, critical

Mortality estimates based on observational studies. Serial SOFA scores (delta-SOFA) may be more predictive than single measurements. An increase in SOFA score during ICU stay is associated with worse outcomes.

Limitations
  • ICU population: SOFA was developed for and validated in ICU patients; may not apply to other settings
  • Sedation: GCS component may be unreliable in sedated patients
  • Chronic conditions: Baseline organ dysfunction may confound scoring
  • Time sensitivity: Laboratory values may lag behind clinical changes
  • Single score vs trends: Serial SOFA scores are more informative than a single measurement
  • Inter-rater variability: Cardiovascular component (vasopressor dosing) may vary between centres
Frequently Asked Questions

The Sequential Organ Failure Assessment (SOFA) score is a scoring system used to track a patient's status in the ICU. It assesses six organ systems (respiratory, cardiovascular, hepatic, coagulation, renal, and neurological) with scores from 0-4 for each, giving a total score of 0-24.

Sepsis-3 (2016) defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction is identified by an acute increase in SOFA score of ≥2 points. Septic shock is defined as sepsis with persisting hypotension requiring vasopressors and lactate >2 mmol/L despite adequate resuscitation.

A SOFA score of 2 or more represents organ dysfunction. Higher scores indicate more severe dysfunction. SOFA ≥2 with suspected infection suggests sepsis. Mortality increases significantly with higher SOFA scores, with scores >11 associated with mortality rates exceeding 50%.

SOFA score should be calculated at ICU admission and then daily (or more frequently if clinical status changes). Serial SOFA scores are valuable for tracking response to treatment - an increasing SOFA suggests deterioration while a decreasing SOFA indicates improvement.
References
  1. Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-710. PubMed
  2. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. PubMed
  3. Ferreira FL, Bota DP, Bross A, et al. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286(14):1754-1758. PubMed
  4. NICE guideline [NG51]: Sepsis: recognition, diagnosis and early management. NICE
  5. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. SCCM
Disclaimer

This calculator is provided for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

  • Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition.
  • Never disregard professional medical advice or delay seeking it because of information from this tool.
  • Clinical decision-making should always incorporate the full clinical context, patient preferences, and local protocols.
  • The creators of this tool accept no liability for decisions made based on its output.

If you are a patient: please discuss any results with your healthcare provider. This tool is designed for use by medical professionals and may not be appropriate for self-assessment.

Quick Reference
SOFA Score Range
  • Total: 0-24 points
  • 6 organ systems × 0-4 points each
  • ≥2 increase = organ dysfunction
Sepsis-3 Criteria

Sepsis: Suspected infection + SOFA ≥2

Septic Shock: Sepsis + vasopressors for MAP ≥65 + lactate >2 mmol/L

Clinical Pearl

Delta-SOFA (change in SOFA over time) may be more valuable than a single measurement. An increasing SOFA during ICU stay is associated with mortality >50%, while a decreasing SOFA indicates response to treatment and lower mortality.