SOFA Score: A Keystone for Grading Multiple Organ Dysfunction

  • J.-L. Vincent
Conference paper


Multiple organ failure is the leading cause of death in critically ill patients. Scoring systems are now widely used in the intensive care unit (ICU) to describe organ dysfunction and predict survival. Early systems focused primarily on survival prediction or the presence or absence of organ failure, but newer scores can describe the evolution of individual and multiple organ dysfunction over time. The sequential organ failure assessment (SOFA) score is one of the most widely used organ dysfunction scores and in this chapter we will discuss its development, its current role in intensive care patients, and its likely use in the future.


Organ Dysfunction Intensive Care Unit Patient Sequential Organ Failure Assessment Sequential Organ Failure Assessment Score Simplify Acute Physiology Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: A severity of disease classification system. Crit Care Med 13:818–829PubMedCrossRefGoogle Scholar
  2. 2.
    Le Gall J-R, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963PubMedCrossRefGoogle Scholar
  3. 3.
    Vincent JL, Moreno R, Takala J et al (1996) The SOFA (sepsis-related organ failure assessment) score to describe organ dysfunction/failure. Intensive Care Med 22:707–710PubMedCrossRefGoogle Scholar
  4. 4.
    Marshall JC, Cook DJ, Christou NV et al (1995) Multiple organ dysfunction score: A reliable descriptor of a complex clinical outcome. Crit Care Med 23:1638–1652PubMedCrossRefGoogle Scholar
  5. 5.
    Fry DE, Pearlstein L, Fulton RL, Hiram CP (1980) Multiple system organ failure: the role of uncontrolled infection. Arch Surg 115:136–140PubMedGoogle Scholar
  6. 6.
    Stevens LE (1983) Gauging the severity of surgical sepsis. Arch Surg 118:1190–1192PubMedGoogle Scholar
  7. 7.
    Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) Prognosis in acute organsystem failure. Ann Surg 202:685–693PubMedCrossRefGoogle Scholar
  8. 8.
    Goris RJ, te Boekhorst TP, Nuytinck JK, Gimbrere JS (1985) Multiple-organ failure, generalized autodestructive inflammation? Arch Surg 120:1109–1115PubMedGoogle Scholar
  9. 9.
    Hebert PC, Drummond AJ, Singer J et al (1993) A simple multiple system organ failure scoring system predicts mortality of patients who have sepsis syndrome. Chest 104:230–235PubMedCrossRefGoogle Scholar
  10. 10.
    Fagon JY, Chastre J, Novara A et al (1993) Characterization of intensive care unit patients using a model based on the presence or absence of organ dysfunctions and/or infection: the ODIN model. Intensive Care Med 19:137–144PubMedCrossRefGoogle Scholar
  11. 11.
    Moreno R, Vincent JL, Matos A et al (1999) The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Intensive Care Med 25:686–696PubMedCrossRefGoogle Scholar
  12. 12.
    Janssens U, Graf C, Graf J et al (2000) Evaluation of the SOFA score: a single centre experience of a medical intensive care unit in 303 consecutive patients with predominantly cardiovascular disorders. Intensive Care Med 26:1037–1045PubMedCrossRefGoogle Scholar
  13. 13.
    Ceriani R, Mazzoni M, Bortone F et al (2003) Application of the sequential organ failure assessment score to cardiac surgical patients. Chest 123:1229–1239PubMedCrossRefGoogle Scholar
  14. 14.
    Patila T, Kukkonen S, Vento A et al (2006) Relation of the sequential organ failure assessment score to morbidity and mortality after cardiac surgery. Ann Thorac Surg 82:2072–2078PubMedCrossRefGoogle Scholar
  15. 15.
    Antonelli M, Moreno R, Vincent JL et al (1999) Application of SOFA score to trauma patients. Sequential Organ Failure Assessment. Intensive Care Med 25:389–394PubMedCrossRefGoogle Scholar
  16. 16.
    Nfor TK, Walsh TS, Prescott RJ (2006) The impact of organ failures and their relationship with outcome in intensive care: analysis of a prospective multicentre database of adult admissions. Anaesthesia 61:731–738PubMedCrossRefGoogle Scholar
  17. 17.
    Vincent JL, de Mendonça A, Cantraine F et al (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicentre, prospective study. Crit Care Med 26:1793–1800PubMedGoogle Scholar
  18. 18.
    Lopes Ferreira F, Peres Bota D, Bross A et al (2001) Serial evaluation of the SOFA score to predict outcome. JAMA 286:1754–1758CrossRefGoogle Scholar
  19. 19.
    Vincent JL (2004) Evidence-based medicine in the ICU: important advances and limitations. Chest 126:592–600PubMedCrossRefGoogle Scholar
  20. 20.
    Vincent JL, Wendon J, Groeneveld J et al (2003) The PIRO Concept: O is for organ dysfunction. Crit Care 7:260–264PubMedCrossRefGoogle Scholar
  21. 21.
    Marshall JC, Vincent JL, Guyatt G et al (2005) Outcome measures for clinical research in sepsis: a report of the 2nd Cambridge Colloquium of the International Sepsis Forum. Crit Care Med 33:1708–1716PubMedCrossRefGoogle Scholar
  22. 22.
    Vincent JL (2004) Endpoints in sepsis trials: more than just 28-day mortality? Crit Care Med 32:S209–S213PubMedCrossRefGoogle Scholar
  23. 23.
    Bernard GR, Vincent JL, Laterre PF et al (2001) Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 344:699–709PubMedCrossRefGoogle Scholar
  24. 24.
    Vincent JL, Angus DC, Artigas A et al (2003) Effects of drotrecogin alfa (activated) on organ dysfunction in the PROWESS trial. Crit Care Med 31:834–840PubMedCrossRefGoogle Scholar
  25. 25.
    Rijnders BJ, Peetermans WE, Verwaest C et al (2004) Watchful waiting versus immediate catheter removal in ICU patients with suspected catheter-related infection: a randomized trial. Intensive Care Med 30:1073–1080PubMedCrossRefGoogle Scholar
  26. 26.
    Vincent JL, Laterre PF, Cohen J et al (2005) A pilot-controlled study of a polymyxin B-immobilized hemoperfusion cartridge in patients with severe sepsis secondary to intra-abdominal infection. Shock 23:400–405PubMedCrossRefGoogle Scholar
  27. 27.
    Spapen HD, Diltoer MW, Nguyen DN et al (2005) Effects of N-acetylcysteine on microalbuminuria and organ failure in acute severe sepsis: results of a pilot study. Chest 127:1413–1419PubMedCrossRefGoogle Scholar
  28. 28.
    Lauzier F, Levy B, Lamarre P, Lesur O (2006) Vasopressin or norepinephrine in early hyperdynamic septic shock: a randomized clinical trial. Intensive Care Med 32:1782–1789PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • J.-L. Vincent
    • 1
  1. 1.Department of Intensive Care, Erasme HospitalFree University of BrusselsBelgium

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