Niknam K, Nesbitt J, Mitarai T, et al. - As illness severity scores aid emergency physicians in stratification of risk to guide earlier transfer to the ICU and assess pre-ICU interventions by adjusting for baseline mortality risk, the SOFA score was adapted to develop a new illness severity score (eccSOFA) that can be determined at the time of ICU admission order entry in the ED using EHR data. Evaluation of this score was done in a cohort of emergency critical care (ECC) patients at a single academic center over a period of 3 years. In-hospital mortality risk was estimated in 3,912 patients; of these, 2,260 patients (57.8%) were in the low-risk group (scores 0–3), 1,203 (30.8%) in the intermediate-risk group (scores 4–7), and 449 (11.5%) in the high-risk group (scores 8+). Findings support the predictive value of eccSOFA for in-hospital mortality. eccSOFA can be determined using variables that are commonly available at the time of critical care admission order entry in the ED and exhibited discriminatory ability comparable to other commonly used illness severity scores.