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pSOFA (Pediatric SOFA)

In months. Sets the age-adjusted cardiovascular (MAP) and renal (creatinine) thresholds.

From an arterial blood gas. When present, PaO₂:FiO₂ is used for the respiratory subscore.

Used only when no PaO₂ is available, and only if ≤97% (above that the ratio saturates).

Room air is 0.21. Accepts a fraction or a percentage. Denominator of the oxygenation ratio.

Invasive or non-invasive ventilation. Required for respiratory subscores 3–4; without it the subscore is capped at 2.

In ×10³/µL (equal to ×10⁹/L).

Accepts mg/dL or µmol/L.

Sets cardiovascular subscore 0 vs 1 by age band. Vasoactive infusions override it for subscores 2–4.

In µg/kg/min. 0 or omitted means not infusing.

In µg/kg/min. Any dose qualifies for cardiovascular subscore 2.

In µg/kg/min. 0 or omitted means not infusing.

In µg/kg/min. 0 or omitted means not infusing.

Total GCS only (3–15). Document sedation/intubation confounders separately.

Accepts mg/dL or µmol/L. Thresholds are age-adjusted.

Independent clinical validation: pending

Two independent clinical validators will be named here once review is complete.

Validator slot open 1
Validator slot open 2

How it is calculated

pSOFA total = respiratory + coagulation + hepatic + cardiovascular + neurologic + renal, six organ subscores (each 0–4) summed to 0–24 (Matics & Sanchez-Pinto 2017); the total and all six subscores are reported. Respiratory uses PaO₂:FiO₂ = PaO₂ ÷ FiO₂ when a PaO₂ is present (≥400 → 0, 300–399 → 1, 200–299 → 2, 100–199 → 3, <100 → 4), otherwise SpO₂:FiO₂ = SpO₂ ÷ FiO₂ but only when SpO₂ ≤97% (≥292 → 0, 264–291 → 1, 221–264 → 2, 148–220 → 3, <148 → 4; an exact 264 takes the worse subscore 2); subscores 3–4 require respiratory support, and a 3/4-band ratio without support is capped at 2. Coagulation from platelets (×10³/µL): ≥150 → 0, 100–149 → 1, 50–99 → 2, 20–49 → 3, <20 → 4. Hepatic from total bilirubin (mg/dL): <1.2 → 0, 1.2–1.9 → 1, 2.0–5.9 → 2, 6.0–11.9 → 3, ≥12 → 4. Cardiovascular is the worse of the MAP subscore (0 if MAP ≥ the age-band threshold, else 1) and the vasoactive subscore (dobutamine any dose or dopamine ≤5 → 2; dopamine >5 or epinephrine ≤0.1 or norepinephrine ≤0.1 → 3; dopamine >15 or epinephrine >0.1 or norepinephrine >0.1 → 4, doses in µg/kg/min). Neurologic from total GCS: 15 → 0, 13–14 → 1, 10–12 → 2, 6–9 → 3, <6 → 4. Renal from serum creatinine (mg/dL) against age-band cut points ≥ the level-4, -3, -2, or -1 threshold. MAP thresholds and creatinine cut points are age-adjusted across seven age bands (<1, 1–11, 12–23, 24–59, 60–143, 144–216, >216 months); missing oxygenation, MAP, or vasoactive inputs score that organ 0.

Limitations and notes

Each subscore is the worst qualifying value in the assessment window; the total is their sum (0–24). Several rules are implementation conventions rather than paper text and are flagged for clinical sign-off [NEEDS SOURCE]: (1) a PaO₂:FiO₂ or SpO₂:FiO₂ in a subscore-3/4 band without respiratory support is capped at 2 (highest non-support band); (2) at the published SpO₂:FiO₂ boundary overlap (264) the higher subscore is assigned. SpO₂:FiO₂ is used only when no PaO₂ is available and only for SpO₂ ≤97% (above that it saturates); an SpO₂ >97% with no PaO₂ scores respiratory 0. Missing oxygenation, MAP, or vasoactive data is treated as normal (0) for that organ, following the SOFA missing-as-normal convention. Physiologic plausibility bounds for PaO₂, platelets, bilirubin, MAP, and creatinine are not specified in the paper [NEEDS SOURCE]; the min/max here are input-validity windows, not clinical thresholds — prefer institutional analyzer limits. The >8 interpretation cut point is a single-center, statistically-derived threshold on the encounter maximum pSOFA and is descriptive, not directive. pSOFA is derived and validated in children beyond the neonatal period; do not over-extend to term neonates without separate evidence (e.g. nSOFA) [NEEDS SOURCE].

Accepted input ranges

  • Patient age — 0–250 months
  • Arterial PaO₂ — 20–600 mmHg
  • Pulse-oximetry SpO₂ — 0–100 %
  • Fraction of inspired oxygen (FiO₂) — 0.21–1 fraction
  • On respiratory support
  • Platelet count — 1–1000 10^3/µL
  • Total bilirubin — 0.1–50 mg/dL
  • Mean arterial pressure — 10–150 mmHg
  • Dopamine infusion rate — 0–50 µg/kg/min
  • Dobutamine infusion rate — 0–40 µg/kg/min
  • Epinephrine infusion rate — 0–5 µg/kg/min
  • Norepinephrine infusion rate — 0–5 µg/kg/min
  • Glasgow Coma Scale total — 3–15
  • Serum creatinine — 0.1–20 mg/dL

References

  1. Matics TJ, Sanchez-Pinto LN. Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children. JAMA Pediatr. 2017;171(10):e172352.PMID 28783810DOI 10.1001/jamapediatrics.2017.2352
  2. Vincent JL, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med. 1996;22(7):707-710.PMID 8844239DOI 10.1007/BF01709751

Version and changelog

v1.0.0 · Organ dysfunction

  • 2026-07-25 v1.0.0 — Initial release: six age-adjusted pSOFA organ subscores and the 0–24 total (Matics 2017).

Important

For use by qualified health professionals as an informational and educational aid. It supports clinical judgment and does not replace it. Verify every result independently before making a clinical decision. This is not a medical device.