SOFA Score Calculator
Sequential Organ Failure Assessment — quantifies organ dysfunction across 6 systems. A SOFA increase of 2+ points from baseline indicates organ dysfunction per Sepsis-3 definitions.
qSOFA (Quick SOFA) — Bedside Screening
Score 0–3 · Bedside tool, no labs needed
Interpretation & Mortality Estimates
Sepsis-3 Definition
Suspected infection + acute SOFA increase of 2 or more points from baseline = Sepsis
Septic Shock
Sepsis + vasopressors to maintain MAP of 65 mmHg or above + lactate > 2 mmol/L despite adequate fluid resuscitation
Dr Sumit's Guide — Clinical Pearls
High-yield points for Indian EM practice
Sepsis-3 (2016) replaced SIRS
SOFA replaced the old SIRS criteria for defining sepsis — more specific for true organ dysfunction. SIRS had poor specificity (tachycardia from pain, fever from viral illness counted).
qSOFA is a screening tool, NOT diagnostic
If qSOFA score is 2 or above, calculate the full SOFA. qSOFA alone should not be used to start or withhold treatment. Sensitivity is only ~50% — a negative qSOFA does NOT rule out sepsis.
Indian tropical infections cause high SOFA scores
Dengue, falciparum malaria, scrub typhus, leptospirosis — common causes of multi-organ dysfunction. They often present with thrombocytopenia (coag SOFA up), hepatic dysfunction (liver SOFA up), and AKI (renal SOFA up) simultaneously.
Serial SOFA (delta-SOFA) matters more
Trend is more valuable than a single value. Increasing SOFA over 48–72 hours indicates worsening. Decreasing SOFA suggests response to treatment. Re-score daily in ICU.
Indian drug names
Noradrenaline = Norad / Levophed, Vasopressin = Vasopin, Dobutamine = Dobutrex. When calculating cardiovascular SOFA, convert doses to µg/kg/min.
Surviving Sepsis Campaign (2021) — 1-Hour Bundle
Measure lactate. Blood cultures BEFORE antibiotics. Start broad-spectrum antibiotics within 1 hour. 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or above. Vasopressors if MAP stays below 65 after fluids.
Common pitfall — baseline SOFA
Baseline SOFA is assumed 0 if no pre-existing organ dysfunction. But many Indian elderly patients have CKD with elevated baseline creatinine — their renal SOFA may already be 1–2 at baseline. Document the baseline to calculate the delta accurately.
Vincent JL, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure.Intensive Care Med. 1996;22(7):707-710. · Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810.