Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score

Sequential Organ Failure Assessment (SOFA) score (now SOFA-1) has not changed since 1996.

The SOFA-2 score, updated to match contemporary practice for organ support of the critically ill patient through an mDelphi and data-driven analyses, maintained 6 organ systems with a score ranging from 0 to 24 (24=worse).

Validated in >3 million ICU patients showing strong predictive validity for ICU mortality in diverse international settings.

Limitations

1. Only ICU mortality was used for predictive validity assessment because ICU outcome alone was collected in all contributing cohorts.

2. Although recommended by the early mDelphi discussions, gastrointestinal and immune system dysfunction were not included in the final SOFA-2 score.

3. The decisions for SOFA-2 thresholds were based on data from the first day of ICU admission. Alternative thresholds may be optimal later in the course of critical illness.

4. The SOFA-2 score was developed and validated only in intensive care patients ; generalizability to patients located outside the ICU, eg, emergency department patients or pediatric care requires future investigation.

Reference

Additionnal ressource (FR)

Thanks to the authors.