{
  "description": "Sequential Organ Failure Assessment (SOFA) score for assessing organ dysfunction in critically ill patients. Evaluates six organ systems (respiratory, cardiovascular, hepatic, coagulation, renal, neurological), each scored 0-4 points. Total score ranges from 0 to 24, with higher scores indicating more severe organ dysfunction.",
  "_filename": "StructureDefinition-mii-pr-icu-score-sofa.json",
  "package_name": "de.medizininformatikinitiative.kerndatensatz.icu",
  "date": null,
  "derivation": "constraint",
  "publisher": "Medizininformatik Initiative",
  "fhirVersion": "4.0.1",
  "name": "MII_PR_ICU_Score_SOFA",
  "abstract": false,
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "MII PR ICU Score SOFA",
  "package_version": "2026.0.0",
  "status": "draft",
  "id": "3b28ba9a-4f11-49e7-8b48-31ff3202b021",
  "kind": "resource",
  "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
  "version": "2026.0.0",
  "differential": {
    "element": [ {
      "id": "Observation.code.coding",
      "min": 1,
      "path": "Observation.code.coding"
    }, {
      "id": "Observation.code.coding:sct",
      "path": "Observation.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "1187491009",
        "system": "http://snomed.info/sct",
        "display": "Sequential Organ Failure Assessment score (observable entity)"
      }
    }, {
      "id": "Observation.code.coding:loinc",
      "min": 1,
      "path": "Observation.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96789-3",
        "system": "http://loinc.org",
        "display": "Sequential Organ Failure Assessment SOFA"
      }
    }, {
      "id": "Observation.value[x]",
      "min": 1,
      "path": "Observation.value[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      }
    }, {
      "id": "Observation.value[x]:valueInteger",
      "max": "1",
      "min": 1,
      "path": "Observation.value[x]",
      "type": [ {
        "code": "integer"
      } ],
      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-score-range",
        "human": "SOFA total score must be between 0 and 24",
        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 24"
      } ]
    }, {
      "id": "Observation.interpretation",
      "path": "Observation.interpretation",
      "short": "Organ dysfunction severity",
      "definition": "Clinical interpretation of SOFA score severity"
    }, {
      "id": "Observation.component",
      "max": "6",
      "min": 6,
      "path": "Observation.component",
      "slicing": {
        "rules": "closed",
        "discriminator": [ {
          "path": "code",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Observation.component:respiratory",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Respiratory component",
      "sliceName": "respiratory",
      "definition": "0: PaO2/FiO2 ≥400 mmHg, 1: PaO2/FiO2 <400 mmHg, 2: PaO2/FiO2 <300 mmHg, 3: PaO2/FiO2 <200 mmHg with respiratory support, 4: PaO2/FiO2 <100 mmHg with respiratory support",
      "mustSupport": true
    }, {
      "id": "Observation.component:respiratory.code.coding",
      "max": "2",
      "min": 2,
      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
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          "path": "coding",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Observation.component:respiratory.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96823-0",
        "system": "http://loinc.org",
        "display": "Respiration [Score] SOFA"
      }
    }, {
      "id": "Observation.component:respiratory.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Respiratory"
      }
    }, {
      "id": "Observation.component:respiratory.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
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        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
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      "id": "Observation.component:respiratory.value[x]:valueInteger",
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      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "integer"
      } ],
      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-component-range",
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        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
      } ]
    }, {
      "id": "Observation.component:cardiovascular",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Cardiovascular component",
      "sliceName": "cardiovascular",
      "definition": "0: MAP ≥70 mmHg, 1: MAP <70 mmHg, 2: Dopamine ≤5 or dobutamine any dose, 3: Dopamine >5 or epinephrine ≤0.1 or norepinephrine ≤0.1, 4: Dopamine >15 or epinephrine >0.1 or norepinephrine >0.1 (all vasopressor doses in µg/kg/min)",
      "mustSupport": true
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      "id": "Observation.component:cardiovascular.code.coding",
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      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
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          "path": "coding",
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        } ]
      }
    }, {
      "id": "Observation.component:cardiovascular.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96826-3",
        "system": "http://loinc.org",
        "display": "Cardiovascular [Score] SOFA"
      }
    }, {
      "id": "Observation.component:cardiovascular.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Cardiovascular"
      }
    }, {
      "id": "Observation.component:cardiovascular.value[x]",
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      "path": "Observation.component.value[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
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    }, {
      "id": "Observation.component:cardiovascular.value[x]:valueInteger",
      "max": "1",
      "min": 1,
      "path": "Observation.component.value[x]",
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        "code": "integer"
      } ],
      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-component-range",
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        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
      } ]
    }, {
      "id": "Observation.component:hepatic",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Hepatic component",
      "sliceName": "hepatic",
      "definition": "0: Bilirubin <1.2 mg/dL (<20 µmol/L), 1: Bilirubin 1.2-1.9 mg/dL (20-32 µmol/L), 2: Bilirubin 2.0-5.9 mg/dL (33-101 µmol/L), 3: Bilirubin 6.0-11.9 mg/dL (102-204 µmol/L), 4: Bilirubin ≥12.0 mg/dL (≥204 µmol/L)",
      "mustSupport": true
    }, {
      "id": "Observation.component:hepatic.code.coding",
      "max": "2",
      "min": 2,
      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
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          "path": "coding",
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        } ]
      }
    }, {
      "id": "Observation.component:hepatic.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96825-5",
        "system": "http://loinc.org",
        "display": "Liver [Score] SOFA"
      }
    }, {
      "id": "Observation.component:hepatic.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Hepatic"
      }
    }, {
      "id": "Observation.component:hepatic.code.text",
      "path": "Observation.component.code.text",
      "patternString": "Hepatic (Bilirubin)"
    }, {
      "id": "Observation.component:hepatic.value[x]",
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      "path": "Observation.component.value[x]",
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        "rules": "open",
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        "discriminator": [ {
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          "type": "type"
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      "id": "Observation.component:hepatic.value[x]:valueInteger",
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      "min": 1,
      "path": "Observation.component.value[x]",
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        "code": "integer"
      } ],
      "sliceName": "valueInteger",
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        "key": "sofa-component-range",
        "human": "SOFA component score must be between 0 and 4",
        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
      } ]
    }, {
      "id": "Observation.component:coagulation",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Coagulation component",
      "sliceName": "coagulation",
      "definition": "0: Platelets ≥150 ×10³/µL, 1: Platelets <150 ×10³/µL, 2: Platelets <100 ×10³/µL, 3: Platelets <50 ×10³/µL, 4: Platelets <20 ×10³/µL",
      "mustSupport": true
    }, {
      "id": "Observation.component:coagulation.code.coding",
      "max": "2",
      "min": 2,
      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
        "discriminator": [ {
          "path": "coding",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Observation.component:coagulation.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96824-8",
        "system": "http://loinc.org",
        "display": "Coagulation [Score] SOFA"
      }
    }, {
      "id": "Observation.component:coagulation.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Coagulation"
      }
    }, {
      "id": "Observation.component:coagulation.code.text",
      "path": "Observation.component.code.text",
      "patternString": "Coagulation (Platelets)"
    }, {
      "id": "Observation.component:coagulation.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
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      "id": "Observation.component:coagulation.value[x]:valueInteger",
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      "path": "Observation.component.value[x]",
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        "code": "integer"
      } ],
      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-component-range",
        "human": "SOFA component score must be between 0 and 4",
        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
      } ]
    }, {
      "id": "Observation.component:renal",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Renal component",
      "sliceName": "renal",
      "definition": "0: Creatinine <1.2 mg/dL (<110 µmol/L), 1: Creatinine 1.2-1.9 mg/dL (110-170 µmol/L), 2: Creatinine 2.0-3.4 mg/dL (171-299 µmol/L), 3: Creatinine 3.5-4.9 mg/dL (300-440 µmol/L) or urine output <500 mL/day, 4: Creatinine ≥5.0 mg/dL (≥440 µmol/L) or urine output <200 mL/day",
      "mustSupport": true
    }, {
      "id": "Observation.component:renal.code.coding",
      "max": "2",
      "min": 2,
      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
        "discriminator": [ {
          "path": "coding",
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        } ]
      }
    }, {
      "id": "Observation.component:renal.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96828-9",
        "system": "http://loinc.org",
        "display": "Renal [Score] SOFA"
      }
    }, {
      "id": "Observation.component:renal.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Renal"
      }
    }, {
      "id": "Observation.component:renal.code.text",
      "path": "Observation.component.code.text",
      "patternString": "Renal (Creatinine or urine output)"
    }, {
      "id": "Observation.component:renal.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
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        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
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    }, {
      "id": "Observation.component:renal.value[x]:valueInteger",
      "max": "1",
      "min": 1,
      "path": "Observation.component.value[x]",
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        "code": "integer"
      } ],
      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-component-range",
        "human": "SOFA component score must be between 0 and 4",
        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
      } ]
    }, {
      "id": "Observation.component:neurological",
      "max": "1",
      "min": 0,
      "path": "Observation.component",
      "short": "Neurological component",
      "sliceName": "neurological",
      "definition": "0: GCS 15, 1: GCS 13-14, 2: GCS 10-12, 3: GCS 6-9, 4: GCS <6",
      "mustSupport": true
    }, {
      "id": "Observation.component:neurological.code.coding",
      "max": "2",
      "min": 2,
      "path": "Observation.component.code.coding",
      "slicing": {
        "rules": "closed",
        "ordered": false,
        "description": "Component codes for SOFA score",
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          "path": "coding",
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      }
    }, {
      "id": "Observation.component:neurological.code.coding:loinc",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "loinc",
      "patternCoding": {
        "code": "96827-1",
        "system": "http://loinc.org",
        "display": "Central nervous system [Score] SOFA"
      }
    }, {
      "id": "Observation.component:neurological.code.coding:sct",
      "max": "1",
      "min": 1,
      "path": "Observation.component.code.coding",
      "sliceName": "sct",
      "patternCoding": {
        "code": "xxxx",
        "system": "http://snomed.info/sct",
        "display": "SOFA Subscore - Neurological"
      }
    }, {
      "id": "Observation.component:neurological.value[x]",
      "min": 1,
      "path": "Observation.component.value[x]",
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    }, {
      "id": "Observation.component:neurological.value[x]:valueInteger",
      "max": "1",
      "min": 1,
      "path": "Observation.component.value[x]",
      "type": [ {
        "code": "integer"
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      "sliceName": "valueInteger",
      "constraint": [ {
        "key": "sofa-component-range",
        "human": "SOFA component score must be between 0 and 4",
        "source": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa",
        "severity": "error",
        "expression": "valueInteger >= 0 and valueInteger <= 4"
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    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "https://www.medizininformatik-initiative.de",
      "system": "url"
    } ]
  } ],
  "baseDefinition": "https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score"
}