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

Does an updated Sequential Organ Failure Assessment (SOFA)-2 score describe organ dysfunction in critically ill patients and its association with intensive care unit (ICU) mortality?The SOFA-2 score was developed and validated in 10 international multicenter cohorts of 3.3 million adult ICU patients. SOFA-2 includes the original 6 organ systems with a total score ranging from 0 to 24 (higher scores indicate worse organ dysfunction). Possible inclusion of immune and gastrointestinal systems was investigated but not added. The updated score now incorporates commonly used drugs and mechanical organ supports that were rarely or not used when the original version was published in 1996. Some thresholds were modified to improve predictive validity against ICU mortality.The SOFA-2 score, updated to include contemporary organ support treatments and new score thresholds, describes organ dysfunction, supported by good predictive validity, in a large, geographically and socioeconomically diverse population of critically ill adults.

Corresponding Author: Rui Moreno MD, PhD, Hospital de São José, ULS de São José, R. José António Serrano, 1150-199, Lisboa, Portugal (r.moreno@mail.telepac.pt).

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