Modified Sequential Organ Failure Assessment (mSOFA) Score

Modified SOFA (mSOFA) Calculator

Respiration (SpO₂/FiO₂)

Coagulation (Platelets ×10³/µL)

Liver (Bilirubin mg/dL)

Cardiovascular (MAP / Vasopressors)

CNS (Glasgow Coma Scale)

Renal (Creatinine mg/dL)

mSOFA Score: 0

Mortality: <10%

Predicts ICU mortality using mostly clinical variables and fewer labs (similar to SOFA Score ).

Why Use

The mSOFA score has similar predictive accuracy without the need for laboratory tests that may not be initially indicated for a critical patient (ABG, LFTs).

When to Use

The mSOFA score has very similar predictive accuracy when compared to the full SOFA score and does not require significant lab testing (ABG, LFTs) to complete. It still uses the same body system components for testing, but estimates P:F ratio using O 2 saturation and FiO 2 ; it estimates liver dysfunction by looking for signs of jaundice or scleral icterus.

Formula

Addition of the selected points: Variable Points Respiratory SpO₂/FiO₂ (see table below for estimating FiO₂ from oxygen flow/delivery rates) >400 0 >315 to ≤400 1 >235 to ≤315 2 >150 to ≤235 3 ≤150 4 Liver Scleral icterus or jaundice present No 0 Yes 3 Cardiovascular Hypotension* No hypotension 0 MAP <70 mmHg 1 DOPamine ≤5 or DOBUTamine (any dose) 2 DOPamine >5, EPINEPHrine ≤0.1, or norEPINEPHrine ≤0.1 3 DOPamine >15, EPINEPHrine >0.1, or norEPINEPHrine >0.1 4 CNS Glasgow Coma Scale ** 15 0 13-14 1 10-12 2 6-9 3 <6 4 Renal Creatinine, mg/dL <1.2 0 1.2-1.9 1 2.0-3.4 2 3.5-4.9 3 >5.0 4 *Based on mean arterial pressure OR administration of vasoactive agents in mcg/kg/min). **Note: "Best"/highest GCS in 24 hr period recommended. Estimating FiO₂ from oxygen flow/delivery rates: Type of O₂ delivery Flow rates, L/min FiO₂ Nasal cannula 1-6 ~4% FiO₂ added above room air* per 1 L/min Room air = 21% 1 L/min = 25% 2 L/min = 29% 3 L/min = 33% 4 L/min = 37% 5 L/min = 41% 6 L/min = 45% Simple face mask ~6-12 35-60%* Non-rebreather mask 10-15 ~70-90% High-flow nasal cannula Up to 60 30-100% *Varies based on respiratory rate and minute ventilation.

Pearls / Pitfalls

The mSOFA score has been externally validated, but is certainly not as widely studied as the SOFA score .

Advice

Understanding goals of care is critically important in all patients, especially those with critical illness. Understanding that a patient has a high risk of mortality may be helpful to the treating medical team as well as to the patient in order to make decisions about their own treatment plan.

More Information

Interpretation: mSOFA Score 30-day mortality 0-7 4% 8-11 31% >11 58% From Grissom 2010 .