Pathophysiology
Clinical meaning
Severity scoring systems are standardized tools used in critical care to quantify illness severity, predict mortality, guide treatment intensity, and facilitate quality benchmarking. Two of the most widely used are SOFA and APACHE II. SOFA Score (Sequential Organ Failure Assessment): Assesses dysfunction in 6 organ systems, each scored 0-4 (total 0-24): 1. Respiratory: PaO2/FiO2 ratio • 0 = ≥400, 1 = <400, 2 = <300, 3 = <200 (with ventilatory support), 4 = <100 (with ventilatory support) 2. Coagulation: Platelet count (×10³/µL) • 0 = ≥150, 1 = <150, 2 = <100, 3 = <50, 4 = <20 3. Liver: Bilirubin (mg/dL) • 0 = <1.2, 1 = 1.2-1.9, 2 = 2.0-5.9, 3 = 6.0-11.9, 4 = >12.0 4. Cardiovascular: Mean Arterial Pressure / Vasopressor dose • 0 = MAP ≥70, 1 = MAP <70, 2 = Dopamine ≤5 or Dobutamine any, 3 = Dopamine >5 or Epi ≤0.1 or Norepi ≤0.1, 4 = Dopamine >15 or Epi >0.1 or Norepi >0.1 5. CNS: Glasgow Coma Scale • 0 = 15, 1 = 13-14, 2 = 10-12, 3 = 6-9,...