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.
package_name: de.medizininformatikinitiative.kerndatensatz.icu
derivation: constraint
name: MII_PR_ICU_Score_SOFA
type: Observation
elements:
  code:
    elements:
      coding:
        index: 0
        slicing:
          slices:
            loinc:
              match: {}
              schema:
                pattern:
                  type: Coding
                  value: {code: 96789-3, system: 'http://loinc.org', display: Sequential Organ Failure Assessment SOFA}
                _required: true
                index: 1
              min: 1
            sct:
              match: {}
              schema:
                pattern:
                  type: Coding
                  value: {code: '1187491009', system: 'http://snomed.info/sct', display: Sequential Organ Failure Assessment score (observable entity)}
                index: 2
    required: [coding]
  value:
    choices: []
    index: 4
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: $this, type: type}
      min: 1
      slices:
        valueInteger:
          match: {}
          schema:
            constraint:
              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}
            choices: [valueInteger]
            _required: true
            index: 6
          min: 1
          max: 1
  valueInteger:
    type: integer
    constraint:
      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}
    choiceOf: value
    index: 7
    slicing:
      slices:
        valueInteger:
          match: {}
          schema:
            type: integer
            constraint:
              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}
            choiceOf: value
            _required: true
            index: 7
          min: 1
          max: 1
  interpretation: {short: Organ dysfunction severity, index: 8}
  component:
    array: true
    min: 6
    max: 6
    index: 9
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: code, type: pattern}
      min: 6
      max: 6
      slices:
        respiratory:
          match: {code: null}
          schema:
            short: Respiratory component
            mustSupport: true
            index: 10
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 11
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96823-0, system: 'http://loinc.org', display: 'Respiration [Score] SOFA'}
                            _required: true
                            index: 12
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Respiratory}
                            _required: true
                            index: 13
                          min: 1
                          max: 1
              value:
                choices: []
                index: 15
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 17
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 18
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 18
                      min: 1
                      max: 1
            required: [value, valueInteger]
        cardiovascular:
          match: {code: null}
          schema:
            short: Cardiovascular component
            mustSupport: true
            index: 19
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 20
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96826-3, system: 'http://loinc.org', display: 'Cardiovascular [Score] SOFA'}
                            _required: true
                            index: 21
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Cardiovascular}
                            _required: true
                            index: 22
                          min: 1
                          max: 1
              value:
                choices: []
                index: 24
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 26
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 27
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 27
                      min: 1
                      max: 1
            required: [value, valueInteger]
        hepatic:
          match: {code: null}
          schema:
            short: Hepatic component
            mustSupport: true
            index: 28
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 29
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96825-5, system: 'http://loinc.org', display: 'Liver [Score] SOFA'}
                            _required: true
                            index: 30
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Hepatic}
                            _required: true
                            index: 31
                          min: 1
                          max: 1
                  text:
                    pattern: {type: String, value: Hepatic (Bilirubin)}
                    index: 32
              value:
                choices: []
                index: 34
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 36
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 37
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 37
                      min: 1
                      max: 1
            required: [value, valueInteger]
        coagulation:
          match: {code: null}
          schema:
            short: Coagulation component
            mustSupport: true
            index: 38
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 39
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96824-8, system: 'http://loinc.org', display: 'Coagulation [Score] SOFA'}
                            _required: true
                            index: 40
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Coagulation}
                            _required: true
                            index: 41
                          min: 1
                          max: 1
                  text:
                    pattern: {type: String, value: Coagulation (Platelets)}
                    index: 42
              value:
                choices: []
                index: 44
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 46
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 47
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 47
                      min: 1
                      max: 1
            required: [value, valueInteger]
        renal:
          match: {code: null}
          schema:
            short: Renal component
            mustSupport: true
            index: 48
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 49
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96828-9, system: 'http://loinc.org', display: 'Renal [Score] SOFA'}
                            _required: true
                            index: 50
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Renal}
                            _required: true
                            index: 51
                          min: 1
                          max: 1
                  text:
                    pattern: {type: String, value: Renal (Creatinine or urine output)}
                    index: 52
              value:
                choices: []
                index: 54
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 56
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 57
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 57
                      min: 1
                      max: 1
            required: [value, valueInteger]
        neurological:
          match: {code: null}
          schema:
            short: Neurological component
            mustSupport: true
            index: 58
            elements:
              code:
                elements:
                  coding:
                    array: true
                    min: 2
                    max: 2
                    index: 59
                    slicing:
                      rules: closed
                      ordered: false
                      description: Component codes for SOFA score
                      discriminator:
                      - {path: coding, type: pattern}
                      min: 2
                      max: 2
                      slices:
                        loinc:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: 96827-1, system: 'http://loinc.org', display: 'Central nervous system [Score] SOFA'}
                            _required: true
                            index: 60
                          min: 1
                          max: 1
                        sct:
                          match: {coding: null}
                          schema:
                            pattern:
                              type: Coding
                              value: {code: xxxx, system: 'http://snomed.info/sct', display: SOFA Subscore - Neurological}
                            _required: true
                            index: 61
                          min: 1
                          max: 1
              value:
                choices: []
                index: 63
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        constraint:
                          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}
                        choices: [valueInteger]
                        _required: true
                        index: 65
                      min: 1
                      max: 1
              valueInteger:
                type: integer
                constraint:
                  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}
                choiceOf: value
                index: 66
                slicing:
                  slices:
                    valueInteger:
                      match: {}
                      schema:
                        type: integer
                        constraint:
                          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}
                        choiceOf: value
                        _required: true
                        index: 66
                      min: 1
                      max: 1
            required: [value, valueInteger]
package_version: 2027.0.0-ballot.3
class: profile
kind: resource
url: https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score-sofa
base: https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-score
version: 2027.0.0-ballot.3
required: [value, valueInteger]