Overview
Clinical Meaning
The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) score are validated clinical scoring systems used in criti...
FNP
FNP
The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) score are validated clinical scoring systems used in critical care to quantify illness severity, predict mortality, guide treatment intensity, and facilitate clinical communication. The SOFA score evaluates six organ systems — respiratory (PaO2/FiO2 ratio), coagulation (platelet count), hepatic (bilirubin), cardiovascular (mean arterial pressure and vasopressor requirements), central nervous system (Glasgow Coma Scale), and renal (creatinine or urine output) — each scored 0–4 for a maximum score of 24. In the Sepsis-3 definition, an acute increase in SOFA score ≥ 2 from baseline defines organ dysfunction attributable to sepsis, with associated mortality increasing from 10% (SOFA 0–6) to > 50% (SOFA ≥ 15). The qSOFA (quick SOFA) serves as a bedside screening tool outside the ICU: altered mental status (GCS < 15), systolic blood pressure ≤ 100 mmHg, and respiratory rate ≥ 22 breaths/minute — 2 or more positive criteria prompt full SOFA assessment and sepsis evaluation. APACHE II uses 12 acute physiologic variables (temperature, MAP, heart rate, respiratory rate, oxygenation, arterial pH, sodium,...
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