The sequential organ failure assessment score (SOFA score), previously known as the sepsis-related organ failure assessment score,[1] is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure.[2][3][4][5][6] The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
SOFA score
A patient's SOFA score assessment
Purpose
determine rate of organ failure
The score tables below only describe points-giving conditions. In cases where the physiological parameters do not match any row, zero points are given. In cases where the physiological parameters match more than one row, the row with most points is picked.
The quick SOFA score (qSOFA) assists health care providers in estimating the risk of morbidity and mortality due to sepsis.[7]
The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients.[8] According to an observational study at an Intensive Care Unit (ICU) in Belgium, the mortality rate is at least 50% when the score is increased, regardless of initial score, in the first 96 hours of admission, 27% to 35% if the score remains unchanged, and less than 27% if the score is reduced.[9] Score ranges from 0 (best) to 24 (worst) points.[10]
< 200 (26.7) and mechanically ventilated including CPAP
< 50
6.0–11.9 [102-204]
3.5–4.9 [300-440] (or < 500 ml/day)
+4
< 6
dopamine > 15 μg/kg/min OR epinephrine > 0.1 μg/kg/min OR norepinephrine > 0.1 μg/kg/min
< 100 (13.3) and mechanically ventilated including CPAP
< 20
> 12.0 [> 204]
> 5.0 [> 440] (or < 200 ml/day)
Quick SOFA scoreedit
The Quick SOFA Score (quickSOFA or qSOFA) was introduced by the Sepsis-3 group in February 2016 as a simplified version of the SOFA Score as an initial way to identify patients at high risk for poor outcome with an infection.[11] The SIRS Criteria definitions of sepsis are being replaced as they were found to possess too many limitations; the "current use of 2 or more SIRS criteria to identify sepsis was unanimously considered by the task force to be unhelpful." The qSOFA simplifies the SOFA score drastically by only including its 3 clinical criteria and by including "any altered mentation" instead of requiring a GCS <15. qSOFA can easily and quickly be repeated serially on patients.
The score ranges from 0 to 3 points. The presence of 2 or more qSOFA points near the onset of infection was associated with a greater risk of death or prolonged intensive care unit stay. These are outcomes that are more common in infected patients who may be septic than those with uncomplicated infection. Based upon these findings, the Third International Consensus Definitions for Sepsis recommends qSOFA as a simple prompt to identify infected patients outside the ICU who are likely to be septic.[12]
qSOFA has also been found to be poorly sensitive though decently specific for the risk of death with SIRS possibly better for screening.[13]
qSOFA utilityedit
The qSOFA was designed to be used in non-ICU settings, where the healthcare provider might not have access to all the information used in the SOFA score. Settings include the emergency department or other healthcare settings where patients are initially assessed. The three criteria used (systolic blood pressure, respiratory rate, and GCS) can be quickly gathered in the emergency department, to risk stratify patients and provide potentially ill patients with quick interventions. This scoring system is used to identify potential patients with sepsis.[14]
In 2019, the surviving sepsis campaign detailed a bundle of medical interventions to be done within the first hour of presentation on septic patients to reduce mortality, so quick identification of these patients with the qSOFA score is important to treat quickly. This group of interventions is the one hour bundle and includes:[15]
Measure lactate level
Draw blood culture before starting antibiotics
Start broad spectrum antibiotics
Rapidly give crystalloid if hypotensive or lactate greater than or equal to 4 mmol/L
Give vasopressors if still hypotensive after crystalloid administration
One study found the one hour bundle to have no significant improvement in in-hospital mortality over patients given the 3 or 6 hour bundles that have been previously recommended by the surviving sepsis campaign.[16]
^Singer, Mervyn; et al. (23 February 2016). "The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)". JAMA. 315 (8): 801–10. doi:10.1001/jama.2016.0287. PMC4968574. PMID 26903338.
^Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM, Thijs LG (Jul 1996). "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine". Intensive Care Med. 22 (7): 707–10. doi:10.1007/bf01709751. PMID 8844239. S2CID 40396839.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Vincent JL, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S (Nov 1998). "Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine". Crit Care Med. 26 (11): 1793–800. doi:10.1097/00003246-199811000-00016. PMID 9824069. S2CID 28070236.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, Takala J, Sprung C, Antonelli M, Bruining H, Willatts S (Jul 1999). "The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Working Group on Sepsis related Problems of the ESICM". Intensive Care Med. 25 (7): 686–96. doi:10.1007/s001340050931. PMID 10470572. S2CID 34510892.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^de Mendonça A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli M, Takala J, Sprung C, Cantraine F (Jul 2000). "Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score". Intensive Care Med. 26 (7): 915–21. doi:10.1007/s001340051281. PMID 10990106. S2CID 24304874.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL (Oct 2001). "Serial evaluation of the SOFA score to predict outcome in critically ill patients". JAMA. 286 (14): 1754–8. doi:10.1001/jama.286.14.1754. PMID 11594901.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^"National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2013". www.hcup-us.ahrq.gov. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved 2017-01-07.
^Vincent, JL; de Mendonca, A; Cantraine, F; Monero, R; Takala, J; Suter, PM; Sprung, CL (November 1998). "Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine". Critical Care Medicine. 26 (11): 1793–800. doi:10.1097/00003246-199811000-00016. PMID 9824069. S2CID 28070236.
^Ferreira, FL; Bota, DP; Bross, A; Melot, C; Vincent, JL (10 October 2001). "Serial evaluation of the SOFA score to predict outcome in critically ill patients". Journal of the American Medical Association. 286 (14): 1754–1758. doi:10.1001/jama.286.14.1754. PMID 11594901.
^Raith, Eamon P.; Udy, Andrew A.; Bailey, Michael; McGloughlin, Steven; MacIsaac, Christopher; Bellomo, Rinaldo; Pilcher, David V.; for the Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resource Evaluation (CORE) (2017-01-17). "Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit". JAMA. 317 (3): 290–300. doi:10.1001/jama.2016.20328. ISSN 0098-7484. PMID 28114553. S2CID 205078408.
^Angus, Derek C.; Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford S.; Klompas, Michael; Levy, Mitchell M.; Martin, Gregory S.; Osborn, Tiffany M.; Rhee, Chanu (2016). "A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria". Critical Care Medicine. 44 (3): e113–e121. doi:10.1097/ccm.0000000000001730. PMC4765912. PMID 26901559.
^"qSOFA :: What is qSOFA?". www.qsofa.org. Retrieved 2016-05-29.
^Fernando, Shannon M.; Tran, Alexandre; Taljaard, Monica; Cheng, Wei; Rochwerg, Bram; Seely, Andrew J.E.; Perry, Jeffrey J. (6 February 2018). "Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection". Annals of Internal Medicine. 168 (4): 266–275. doi:10.7326/M17-2820. PMID 29404582. S2CID 3441582.
^Norse, Ashley; Guirgis, Faheem. "Updates and Controversies in the Early Management of Sepsis and Septic Shock | EB Medicine". www.ebmedicine.net. EBMedicine.
^"Hour-1 Bundle" (PDF). Surviving Sepsis Campaign. Society of Critical Care Medicine and the European Society of Intensive Care Medicine.
^Ko, BS; Choi, SH; Shin, TG; Kim, K; Jo, YH; Ryoo, SM; Park, YS; Kwon, WY; Choi, HS; Chung, SP; Suh, GJ; Kang, H; Lim, TH; Son, D; Kim, WY (2 February 2021). "Impact of 1-Hour Bundle Achievement in Septic Shock". Journal of Clinical Medicine. 10 (3): 527. doi:10.3390/jcm10030527. PMC7867161. PMID 33540513.
External linksedit
Janssens U; et al. (2001). "Value of SOFA (Sequential Organ Failure Assessment) score and total maximum SOFA score in 812 patients with acute cardiovascular disorders". Crit Care. 5 (S1): P225. doi:10.1186/cc1292. PMC3333412.
May 09, 2024
sofa, score, sequential, organ, failure, assessment, score, previously, known, sepsis, related, organ, failure, assessment, score, used, track, person, status, during, stay, intensive, care, unit, determine, extent, person, organ, function, rate, failure, scor. The sequential organ failure assessment score SOFA score previously known as the sepsis related organ failure assessment score 1 is used to track a person s status during the stay in an intensive care unit ICU to determine the extent of a person s organ function or rate of failure 2 3 4 5 6 The score is based on six different scores one each for the respiratory cardiovascular hepatic coagulation renal and neurological systems SOFA scoreA patient s SOFA score assessmentPurposedetermine rate of organ failure The score tables below only describe points giving conditions In cases where the physiological parameters do not match any row zero points are given In cases where the physiological parameters match more than one row the row with most points is picked The quick SOFA score qSOFA assists health care providers in estimating the risk of morbidity and mortality due to sepsis 7 Contents 1 Medical use 2 Quick SOFA score 2 1 qSOFA utility 3 See also 4 References 5 External linksMedical use editThe SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients 8 According to an observational study at an Intensive Care Unit ICU in Belgium the mortality rate is at least 50 when the score is increased regardless of initial score in the first 96 hours of admission 27 to 35 if the score remains unchanged and less than 27 if the score is reduced 9 Score ranges from 0 best to 24 worst points 10 Central nervous system Cardiovascular system Respiratory system Coagulation Liver Renal function Score Glasgow coma scale Mean arterial pressure OR administration of vasopressors required PaO2 FiO2 mmHg kPa Platelets 103 ml Bilirubin mg dl mmol L Creatinine mg dl mmol L or urine output 0 15 MAP 70 mmHg 400 53 3 150 lt 1 2 lt 20 lt 1 2 lt 110 1 13 14 MAP lt 70 mmHg lt 400 53 3 lt 150 1 2 1 9 20 32 1 2 1 9 110 170 2 10 12 dopamine 5 mg kg min or dobutamine any dose lt 300 40 lt 100 2 0 5 9 33 101 2 0 3 4 171 299 3 6 9 dopamine gt 5 mg kg min OR epinephrine 0 1 mg kg min OR norepinephrine 0 1 mg kg min lt 200 26 7 and mechanically ventilated including CPAP lt 50 6 0 11 9 102 204 3 5 4 9 300 440 or lt 500 ml day 4 lt 6 dopamine gt 15 mg kg min OR epinephrine gt 0 1 mg kg min OR norepinephrine gt 0 1 mg kg min lt 100 13 3 and mechanically ventilated including CPAP lt 20 gt 12 0 gt 204 gt 5 0 gt 440 or lt 200 ml day Quick SOFA score editThe Quick SOFA Score quickSOFA or qSOFA was introduced by the Sepsis 3 group in February 2016 as a simplified version of the SOFA Score as an initial way to identify patients at high risk for poor outcome with an infection 11 The SIRS Criteria definitions of sepsis are being replaced as they were found to possess too many limitations the current use of 2 or more SIRS criteria to identify sepsis was unanimously considered by the task force to be unhelpful The qSOFA simplifies the SOFA score drastically by only including its 3 clinical criteria and by including any altered mentation instead of requiring a GCS lt 15 qSOFA can easily and quickly be repeated serially on patients Assessment qSOFA score Low blood pressure SBP 100 mmHg 1 High respiratory rate 22 breaths min 1 Altered mentation GCS 14 1 The score ranges from 0 to 3 points The presence of 2 or more qSOFA points near the onset of infection was associated with a greater risk of death or prolonged intensive care unit stay These are outcomes that are more common in infected patients who may be septic than those with uncomplicated infection Based upon these findings the Third International Consensus Definitions for Sepsis recommends qSOFA as a simple prompt to identify infected patients outside the ICU who are likely to be septic 12 qSOFA has also been found to be poorly sensitive though decently specific for the risk of death with SIRS possibly better for screening 13 qSOFA utility edit The qSOFA was designed to be used in non ICU settings where the healthcare provider might not have access to all the information used in the SOFA score Settings include the emergency department or other healthcare settings where patients are initially assessed The three criteria used systolic blood pressure respiratory rate and GCS can be quickly gathered in the emergency department to risk stratify patients and provide potentially ill patients with quick interventions This scoring system is used to identify potential patients with sepsis 14 In 2019 the surviving sepsis campaign detailed a bundle of medical interventions to be done within the first hour of presentation on septic patients to reduce mortality so quick identification of these patients with the qSOFA score is important to treat quickly This group of interventions is the one hour bundle and includes 15 Measure lactate level Draw blood culture before starting antibiotics Start broad spectrum antibiotics Rapidly give crystalloid if hypotensive or lactate greater than or equal to 4 mmol L Give vasopressors if still hypotensive after crystalloid administration One study found the one hour bundle to have no significant improvement in in hospital mortality over patients given the 3 or 6 hour bundles that have been previously recommended by the surviving sepsis campaign 16 See also editAPACHE IIReferences edit Singer Mervyn et al 23 February 2016 The Third International Consensus Definitions for Sepsis and Septic Shock Sepsis 3 JAMA 315 8 801 10 doi 10 1001 jama 2016 0287 PMC 4968574 PMID 26903338 Vincent JL Moreno R Takala J Willatts S De Mendonca A Bruining H Reinhart CK Suter PM Thijs LG Jul 1996 The SOFA Sepsis related Organ Failure Assessment score to describe organ dysfunction failure On behalf of the Working Group on Sepsis Related Problems of the European Society of Intensive Care Medicine Intensive Care Med 22 7 707 10 doi 10 1007 bf01709751 PMID 8844239 S2CID 40396839 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Vincent JL de Mendonca A Cantraine F Moreno R Takala J Suter PM Sprung CL Colardyn F Blecher S Nov 1998 Use of the SOFA score to assess the incidence of organ dysfunction failure in intensive care units results of a multicenter prospective study Working group on sepsis related problems of the European Society of Intensive Care Medicine Crit Care Med 26 11 1793 800 doi 10 1097 00003246 199811000 00016 PMID 9824069 S2CID 28070236 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Moreno R Vincent JL Matos R Mendonca A Cantraine F Thijs L Takala J Sprung C Antonelli M Bruining H Willatts S Jul 1999 The use of maximum SOFA score to quantify organ dysfunction failure in intensive care Results of a prospective multicentre study Working Group on Sepsis related Problems of the ESICM Intensive Care Med 25 7 686 96 doi 10 1007 s001340050931 PMID 10470572 S2CID 34510892 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link de Mendonca A Vincent JL Suter PM Moreno R Dearden NM Antonelli M Takala J Sprung C Cantraine F Jul 2000 Acute renal failure in the ICU risk factors and outcome evaluated by the SOFA score Intensive Care Med 26 7 915 21 doi 10 1007 s001340051281 PMID 10990106 S2CID 24304874 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Ferreira FL Bota DP Bross A Melot C Vincent JL Oct 2001 Serial evaluation of the SOFA score to predict outcome in critically ill patients JAMA 286 14 1754 8 doi 10 1001 jama 286 14 1754 PMID 11594901 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link National Inpatient Hospital Costs The Most Expensive Conditions by Payer 2013 www hcup us ahrq gov Rockville MD Agency for Healthcare Research and Quality Retrieved 2017 01 07 Vincent JL de Mendonca A Cantraine F Monero R Takala J Suter PM Sprung CL November 1998 Use of the SOFA score to assess the incidence of organ dysfunction failure in intensive care units results of a multicenter prospective study Working group on sepsis related problems of the European Society of Intensive Care Medicine Critical Care Medicine 26 11 1793 800 doi 10 1097 00003246 199811000 00016 PMID 9824069 S2CID 28070236 Ferreira FL Bota DP Bross A Melot C Vincent JL 10 October 2001 Serial evaluation of the SOFA score to predict outcome in critically ill patients Journal of the American Medical Association 286 14 1754 1758 doi 10 1001 jama 286 14 1754 PMID 11594901 Raith Eamon P Udy Andrew A Bailey Michael McGloughlin Steven MacIsaac Christopher Bellomo Rinaldo Pilcher David V for the Australian and New Zealand Intensive Care Society ANZICS Centre for Outcomes and Resource Evaluation CORE 2017 01 17 Prognostic Accuracy of the SOFA Score SIRS Criteria and qSOFA Score for In Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit JAMA 317 3 290 300 doi 10 1001 jama 2016 20328 ISSN 0098 7484 PMID 28114553 S2CID 205078408 Angus Derek C Seymour Christopher W Coopersmith Craig M Deutschman Clifford S Klompas Michael Levy Mitchell M Martin Gregory S Osborn Tiffany M Rhee Chanu 2016 A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria Critical Care Medicine 44 3 e113 e121 doi 10 1097 ccm 0000000000001730 PMC 4765912 PMID 26901559 qSOFA What is qSOFA www qsofa org Retrieved 2016 05 29 Fernando Shannon M Tran Alexandre Taljaard Monica Cheng Wei Rochwerg Bram Seely Andrew J E Perry Jeffrey J 6 February 2018 Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection Annals of Internal Medicine 168 4 266 275 doi 10 7326 M17 2820 PMID 29404582 S2CID 3441582 Norse Ashley Guirgis Faheem Updates and Controversies in the Early Management of Sepsis and Septic Shock EB Medicine www ebmedicine net EBMedicine Hour 1 Bundle PDF Surviving Sepsis Campaign Society of Critical Care Medicine and the European Society of Intensive Care Medicine Ko BS Choi SH Shin TG Kim K Jo YH Ryoo SM Park YS Kwon WY Choi HS Chung SP Suh GJ Kang H Lim TH Son D Kim WY 2 February 2021 Impact of 1 Hour Bundle Achievement in Septic Shock Journal of Clinical Medicine 10 3 527 doi 10 3390 jcm10030527 PMC 7867161 PMID 33540513 External links editJanssens U et al 2001 Value of SOFA Sequential Organ Failure Assessment score and total maximum SOFA score in 812 patients with acute cardiovascular disorders Crit Care 5 S1 P225 doi 10 1186 cc1292 PMC 3333412 Retrieved from https en wikipedia org w index php title SOFA score amp oldid 1193623013 Quick SOFA score, wikipedia, wiki, book, books, library,
