[Innovations in organ function assessment in critically ill patients: insights from the updated SOFA-2 score]

Critically ill patients have a high incidence of organ dysfunction, and how to accurately and effectively assess organ function has long been a focus of attention. The Sequential Organ Failure Assessment (SOFA) score, an important tool for evaluating organ dysfunction, has been widely used in clinical practice for nearly 30 years, but it still has certain limitations. The SOFA-2 score, released in 2025 by a team of 60 experts from 9 countries specializing in critical care medicine, epidemiology, and data science, has achieved a significant upgrade from an assessment tool to a standardized system by optimizing variable definitions, updating thresholds, and clarifying standardized rules, with the potential to improve its clinical applicability. The promotion of SOFA-2 is of great value for strengthening the stratified management of critically ill patients and enhancing the quality of clinical research. This article aims to systematically expound on the main updates of SOFA-2, its core differences from SOFA-1, and recommendations for clinical application, as well as analyze the current challenges and its impact on the practice and research of critical care medicine, in order to provide a reference for the accurate understanding and application of this score.