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Calculator: CLIF-SOFA score for adults with acute-on-chronic liver disease


Calculator: CLIF-SOFA score for adults with acute-on-chronic liver disease

 
Lungs (respiration)

PaO2/FiO2 >400 or SpO2/FiO2 >512 (0 points)

PaO2/FiO2 301 to 400 or SpO2/FiO2 358 to 512 (1 point)

PaO2/FiO2 201 to 300 or SpO2/FiO2 215 to 357 (2 points)

PaO2/FiO2 101 to 200 or SpO2/FiO2 90 to 214 (3 points)

PaO2/FiO2 ≤100 or SpO2/FiO2 ≤89 (4 points)
Coagulation (international normalized ratio)

<1.1 (0 points)

1.1 to 1.24 (1 point)

1.25 to 1.49 (2 points)

1.5 to 2.49 (3 points)

≥2.5 or platelet count ≤20 x109/L (4 points)
Liver (bilirubin)

<1.2 mg/dL (<20 mcmol/L) (0 points)

1.2 to 1.9 mg/dL (20 to 32 mcmol/L) (1 point)

2 to 5.9 mg/dL (33 to 101 mcmol/L) (2 points)

6 to 11.9 mg/dL (102 to 203 mcmol/L) (3 points)

≥12 mg/dL (≥204 mcmol/L) (4 points)
Circulation (mean arterial blood pressure)

Mean arterial pressure ≥70 mmHg (0 points)

Mean arterial pressure <70 mmHg (1 point)

On dopamine ≤5 mcg/kg/min, or any dobutamine or terlipressin (2 points)

On dopamine >5 mcg/kg/min, E ≤0.1 mcg/kg/min, or NE ≤0.1 mcg/kg/min (3 points)

On dopamine >15 mcg/kg/min, E >0.1 mcg/kg/min, or NE >0.1 mcg/kg/min (4 points)
Cerebral (HE grade)*

No HE (0 points)

Grade I HE: euphoria/depression; mild confusion; slurred speech; disordered sleep (1 point)

Grade II HE: lethergy; moderate confusion (2 points)

Grade III HE: marked confusion; incoherent; sleeping but arousable (3 points)

Grade IV HE: coma (4 points)
Kidney (creatinine)

Creatinine <1.2 mg/dL (<110 mcmol/L) (0 points)

Creatinine 1.2 to 1.9 mg/dL (110 to 170 mcmol/L) (1 point)

Creatinine 2 to 3.4 mg/dL (171 to 299 mcmol/L) (2 points)

Creatinine 3.5 to 4.9 mg/dL (300 to 439 mcmol/L) (3 points)

Creatinine ≥5 mg/dL (≥440 mcmol/L) or use of renal replacement therapy (4 points)

 
Important: Inputs must be complete to perform calculation.

 
Total criteria point count:
 

 
Notes
  • * Patients with grade I encephalopathy may have mild asterixis, whereas pronounced asterixis is seen in patients with grade II or III encephalopathy. Asterixis is typically absent in patients with grade IV encephalopathy, who instead may demonstrate decorticate or decerebrate posturing.[1]
  • For patients with cirrhosis, the CLIF-SOFA score helps predict in-hospital mortality and determine the overall severity of illness (eg, spontaneous bacterial peritonitis).[2] Refer to UpToDate content on treatment of spontaneous bacterial peritonitis.
  • CLIF-SOFA: chronic liver failure-sequential organ failure assessment;[3] HE: hepatic encephalopathy; E: epinephrine; NE: norepinephrine; PaO2: partial pressure (arterial) oxygen; FiO2: fraction inspired oxygen; SpO2: oxygen saturation by pulse oximetry; EEG: electroencephalogram.

 
Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

Information on this page may not appear correctly if printed.

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