Grading severity of sepsis

  • J.-L. Vincent
  • D. Peres-Bota
  • F. Ferreira
Conference paper


The ability to determine and grade the severity of any disease process provides a means of characterizing individual patients, enabling comparison of patient groups and assessment of the effects of treatment on morbidity and disease progression. Such techniques may be particularly useful in the clinical trial setting, but can also be applied to everyday clinical practice. We will briefly discuss recent concepts in definitions of sepsis, before concentrating on the grading of disease severity by measurement of organ dysfunction. Several scoring systems have been developed that allow analysis of the degree of individual and total organ dysfunction in such patients, and we will briefly discuss the basic rationale behind them before focusing in on the most widely used, the Sequential Organ Failure Assessment (SOFA) score.


Organ Dysfunction Sequential Organ Failure Assessment Severe Acute Pancreatitis Sequential Organ Failure Assessment Score Drotrecogin Alfa 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Vincent JL (2002) Sepsis definitions. Lancet Infect Dis 2:135PubMedCrossRefGoogle Scholar
  2. 2.
    Goris RJ, te Boekhorst TP, Nuytinck JK, et al (1985) Multiple-organ failure. Generalized autodestmctive inflammation? Arch Surg 120:1109–1115PubMedCrossRefGoogle Scholar
  3. 3.
    Marshall JC, Christou NV, Horn R et al (1988) The microbiology of multiple organ failure. Arch Surg 123:309–315PubMedCrossRefGoogle Scholar
  4. 4.
    Vincent JL, Mendonça A de, 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 multicentric, prospective study. Crit Care Med 26:1793–1800PubMedCrossRefGoogle Scholar
  5. 5.
    Marshall JC, Christou NV, Meakins JL (1993) The gastrointestinal tract. The “undrained abscess” of multiple organ failure. Ann Surg 218:111–119PubMedCrossRefGoogle Scholar
  6. 6.
    Dantzker DR (1993) The gastrointestinal tract: The canary of the body ? JAMA 270:1247–1248PubMedCrossRefGoogle Scholar
  7. 7.
    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
  8. 8.
    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
  9. 9.
    Elebute EA, Stoner HB (1983) The grading of sepsis. Br J Surg 70:29–31PubMedCrossRefGoogle Scholar
  10. 10.
    Le Gall JR, Klar J, Lemeshow S, et al (1996) The logistic organ dysfunction system: a new way to assess organ dysfunction in the intensive care unit. JAMA 276:802–810PubMedCrossRefGoogle Scholar
  11. 11.
    Peres Bota D, Melot C, Lopez F, Nguyen B V, Vincent JL (2002) MODS vs SOFA score: is anyone better for outcome prediction? (abstract) Eur J Anaesth 19:162 (Abst)Google Scholar
  12. 12.
    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
  13. 13.
    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
  14. 14.
    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 predominantìy cardiovascular disorders. Intensive Care Med 26:1037–1045PubMedCrossRefGoogle Scholar
  15. 15.
    AntoneUi M, Moreno R, Vincent JL, et al (1999) Application of SOFA score to trauma patients. Sequential Organ Failure Assessment. Intensive Care Med 25:389–394CrossRefGoogle Scholar
  16. 16.
    Halonen KI, Rettila V, Leppaniemi AK, et al (2002) Multiple organ dysfunction associated with severe acute pancreatitis. Crit Care Med 30:1274–1279PubMedCrossRefGoogle Scholar
  17. 17.
    Briegel J, Forst H, Haller M, et al (1999) Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study. Crit Care Med 27:723–732PubMedCrossRefGoogle Scholar
  18. 18.
    Fagon JY, Chastre J, Wolff M, et al (2000) Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med 132:621–630PubMedCrossRefGoogle Scholar
  19. 19.
    Panacek EA, Marshall J, Fischkoff S, Barchuk W, Leah T (2000) Neutralization of TNF by a monoclonal antibody improves survival and reduces organ dysfunction in human sepsis: results of the MONARCS trial.(abstract) Chest 118:88SGoogle Scholar
  20. 20.
    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

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • J.-L. Vincent
  • D. Peres-Bota
  • F. Ferreira

There are no affiliations available

Personalised recommendations