Impact of the updated SOFA-2 score on sepsis diagnosis and prognosis: a retrospective multicenter cohort study
Authors' conclusion
SOFA-1 and SOFA-2 showed high concordance in sepsis detection, yet each identified distinct patient subgroups with significant mortality.
Study context
- Population
- Adults with suspected infection within 72 h of intensive care unit (ICU) admission
- Participants
- 74,615 adults
- Exposure
- Sepsis-3 identified with SOFA-2 vs Sequential Organ Failure Assessment (SOFA-1)
- Outcome
- ICU mortality
Methodological detailsmulticentre, three ICU databases (US and Netherlands)
- Multicentre
- Three ICU databases (US and Netherlands)
Main finding
As reported in the abstract
SOFA-1 Only vs Neither: P = 0.002 · SOFA-2 Only vs Neither: P = 2.87 × 10-15
Observational data: associations, not effects.
Secondary outcomes
| Outcome | SOFA-1 Only | SOFA-2 Only | P value |
|---|---|---|---|
| Diagnostic concordance of sepsis | 3.54% | 6.84% | |
| AUROC of prognostic models for ICU mortality, internal cross-validationSOFA-2 vs SOFA-1 | 0.728 | 0.736 | P = 0.386 |
| AUROC of prognostic models for ICU mortality, external validationSOFA-2 vs SOFA-1 | 0.720 | 0.743 | P = 0.375 |
- Diagnostic concordance of sepsis — Concordance between SOFA-1 and SOFA-2
- 89.62%
Diagnostic concordance of sepsis
- Discrepancies mainly due to respiratory and renal scoring updates
Timeliness of diagnosis (Concordant Positive)
- Diagnosed simultaneously by both
- 61.24%
- Earlier diagnosis by SOFA-2
- 23.12%
- Earlier diagnosis by SOFA-1
- 15.64%
- Heterogeneity across databases
Original publication
Impact of the updated SOFA-2 score on sepsis diagnosis and prognosis: a retrospective multicenter cohort study. Crit Care. Published 6 May 2026. doi:10.
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