ArticleJournal of intensive care2026
The new SOFA for sepsis identification and mortality prediction: a multicenter cohort study.
Article in Journal of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
18 authors.
Funding
Abstract
backgroundThe Sequential Organ Failure Assessment (SOFA) score is central to Sepsis-3 criteria. SOFA-2 updates thresholds and incorporates contemporary organ support practices, but its impact on sepsis identification and outcome prediction remains uncertain. This study aimed to compare the diagnostic yield and prognostic performance of SOFA-2 versus SOFA-1 for sepsis identification in critically ill adults.
methodsWe conducted a retrospective multicenter cohort study of 11,669 ICU admissions from three tertiary hospitals in China (January 2022-October 2025) and externally validated findings in 29,811 ICU patients from MIMIC-IV. Sepsis was defined by Sepsis-3 using either SOFA-1 or SOFA-2. We evaluated diagnostic agreement, organ dysfunction profiles, and discrimination for ICU mortality.
resultsSOFA-2 identified a significantly larger sepsis population than SOFA-1 (49.0% vs. 45.5%, P < 0.001), while maintaining substantial diagnostic agreement with SOFA-1 (
conclusionThe updated SOFA-2 score may identify a moderately larger sepsis population with more advanced organ dysfunction and may provide modestly improved mortality risk stratification compared with SOFA-1, while maintaining substantial diagnostic agreement. These findings suggest that SOFA-2 could be considered for clinical use in ICU sepsis assessment, and the Sepsis-3 SOFA ≥ 2 threshold may not require recalibration when using SOFA-2.
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