SOFA score calculator (Sequential Organ Failure Assessment)

How this SOFA score calculator works

This SOFA score calculator gives 0 to 4 points to each of six organ systems and adds them, so the Sequential Organ Failure Assessment runs from 0, normal function, to 24, severe failure of all six. Vincent and colleagues published the score in Intensive Care Medicine in 1996 for the European Society of Intensive Care Medicine's working group on sepsis-related problems, under its first name, the Sepsis-related Organ Failure Assessment. As its title says, it was designed to describe organ dysfunction and failure, and a 1998 study in 40 ICUs found that regular, repeated scoring tracks how a patient's condition develops. The six systems are respiration (PaO2/FiO2 ratio), coagulation (platelets), liver (bilirubin), cardiovascular (mean arterial pressure and vasopressor support), central nervous system (Glasgow Coma Scale) and renal (creatinine or urine output). The cut-offs below follow Table 1 of the Sepsis-3 consensus (Singer and colleagues, JAMA 2016), which adapts Vincent's table. Enter one value per organ, taken over the same time window, for the total.

SOFA points by organ system (Sepsis-3 Table 1, adapted from Vincent 1996). PaO2/FiO2 is in mmHg (kPa), platelets in ×10³/µL, and bilirubin and creatinine in mg/dL (µmol/L).

The cardiovascular row scores 2, 3 or 4 by which catecholamine is running (dopamine, dobutamine, epinephrine or norepinephrine) and in which rate band, given for at least 1 hour. This page does not restate those rates: choose the cardiovascular points directly, reading the bands from Table 1 of Singer 2016 or from Vincent 1996. A PaO2/FiO2 ratio below 200 scores 3 or 4 only with respiratory support; without it, this calculator scores 2. For the renal row, the higher of the creatinine and urine output points counts. A value that falls in a gap of the published table, such as a creatinine of exactly 5.0 mg/dL, is scored in the higher band.

SOFA score results and what they mean

A SOFA score result is read two ways: as a total that tracks how many organs are failing and how badly, and, under Sepsis-3, as a change from the patient's baseline. The Sepsis-3 task force (Singer and colleagues, JAMA 2016) defines sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, and identifies that organ dysfunction as an acute rise in total SOFA of 2 points or more consequent to the infection. The baseline can be assumed to be 0 in patients not known to have preexisting organ dysfunction. Sepsis-3 states that a SOFA score of 2 or more reflects an overall mortality risk of about 10% in a general hospital population with suspected infection, and that depending on baseline risk it identified a 2- to 25-fold higher risk of dying than a score below 2. For ICU patients, Ferreira and colleagues linked higher and rising scores with higher mortality, as the second table shows.

SOFA totals and trends in the ICU, from Ferreira 2001 (352 adults in a 31-bed ICU in Belgium, scored on admission and every 48 hours):

When the SOFA score is less reliable

The SOFA score is less reliable when its inputs reflect treatment or missing data rather than the disease itself. Sepsis-3 notes that SOFA is not intended as a tool for patient management but as a way to characterize a septic patient, that its laboratory parts (creatinine, bilirubin, platelets and PaO2) may not capture dysfunction in one organ system promptly, and that the cardiovascular score can be changed by iatrogenic interventions. Treatment also moves the score: the respiratory and cardiovascular rows depend on respiratory and vasopressor support, and sedation lowers the Glasgow Coma Scale. The 2-point rule depends on a baseline that is often unknown; taking it as 0 counts chronic kidney or liver disease as new dysfunction. Outside the ICU, Seymour 2016 found qSOFA predicted in-hospital death slightly better than SOFA (AUROC 0.81 vs 0.79). In 2025 an international group published SOFA-2 in JAMA, with new variables and revised thresholds; this calculator uses the original 1996 score that Sepsis-3 cites.