The SOFA system was created in a consensus meeting of the European Society of Intensive Care Medicine in 1994 and further revised in 1996. The SOFA is a six-organ dysfunction/failure score measuring multiple organ failure daily. Each organ is graded from 0 (normal) to 4 (the most abnormal), providing a daily score of 0 to 24 points. The objective in the development of the SOFA was to create a simple, reliable, and continuous score easily obtained in every institution.
Critical Care
Guidelines for Intensive Care Unit Admission for Severe Community-Acquired Pneumonia (CAP)
The Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) recently reviewed risk factors and developed objective major and minor criteria to identify patients who require direct admission to an Intensive Care Unit (ICU). The most up-to-date definitions use need for invasive mechanical ventilation or septic shock, requiring vasopressors, as absolute indicators for direct admission to an ICU. For patients who do not meet either of these two major criteria, minor criteria have been proposed that are based on CURB-65 and ATS criteria with new additions. For admission to an ICU or high level unit, patients must fulfill at least three of these minor criteria.
Clinical Criteria for Do-Not-Resuscitate (DNR) Orders in Acute Stroke
A DNR order may be written any time that two of the following clinical criteria are present and the prognosis has become clear for and shared whenever possible between physician(s), patient, and family (or appropriate surrogate).
Knaus Criteria for Multiple System Organ Failure (MSOF)
Multiple systems organ failure is said present when more than one of the system dysfunctions detected by test values exceeding the threshold values.
Glasgow Coma Score
The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma. The total score is the sum of the scores in three categories. For adults the scores are as follows:
FOUR Score for Comatose Patients
The Full Outline of UnResponsiveness (FOUR) score provides greater neurological detail than the Glasgow Coma Scale (GCS), recognizes a locked-in syndrome, and is superior to the GCS due to the availability of brainstem reflexes, breathing patterns, and the ability to recognize different stages of herniation.
The APACHE II Severity of Disease Classification System
APACHE II uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status to provide a general measure of severity of disease.