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SOFA Score in Sepsis: What Every Intensivist Needs to Know

Understanding the Sequential Organ Failure Assessment (SOFA) score for sepsis diagnosis and prognosis. Learn qSOFA screening and organ dysfunction criteria.

Quick Medical Calculator Team · December 11, 2025 · 3 min read

Understanding SOFA in Sepsis-3

The 2016 Sepsis-3 definitions redefined sepsis using SOFA score. A SOFA score increase of ≥2 points in the setting of suspected infection indicates sepsis.

SOFA Score Components

Respiratory (PaO2/FiO2)

• ≥400: 0 points
• 300-399: 1 point
• 200-299: 2 points
• 100-199 with respiratory support: 3 points
• <100 with respiratory support: 4 points

Cardiovascular (MAP or vasopressors)

• MAP ≥70: 0 points
• MAP <70: 1 point
• Dopamine ≤5 or dobutamine: 2 points
• Dopamine >5 or epi/norepi ≤0.1: 3 points
• Dopamine >15 or epi/norepi >0.1: 4 points

Hepatic (Bilirubin)

• <1.2 mg/dL: 0 points
• 1.2-1.9: 1 point
• 2.0-5.9: 2 points
• 6.0-11.9: 3 points
• ≥12.0: 4 points

qSOFA: Bedside Screening

For patients outside the ICU, use qSOFA:

• Respiratory rate ≥22
• Altered mentation (GCS <15)
• Systolic BP ≤100 mmHg

≥2 criteria = high risk for poor outcomes

Clinical Application

1. Baseline SOFA assumed to be 0 if no prior organ dysfunction
2. Serial SOFA scores track response to therapy
3. Higher scores = higher mortality