BACKGROUND: Data on the use of sequential organ failure assessment (SOFA) in patients with cardiovascular disease are increasing. Several studies demonstrated that the SOFA score can identify short-term mortality in patients with acute decompensated heart failure (ADHF). This study was conducted to determine the prognostic value of the admission SOFA score in patients hospitalized for ADHF and to assess its ability in predicting the 30-day readmission rate. MATERIALS AND METHODS: This study was conducted from July 2022 to August 2023 at our institution. A total of 216 patients were included in the study, and the SOFA score was calculated for all patients. RESULTS: The average SOFA score is 3.14 ± 2.67, of which SOFA scores of ≤1, 2-3, and ≥4 account for 34.3%, 27.8%, and 37.9% of the total score, respectively. During the 30-day follow-up period, there were 22 cases of death from all causes (10.2%), of which in-hospital mortality accounted for 9.7%. Patients with all-cause mortality had higher SOFA scores than the survivors (7.32 ± 2.93 and 2.66 ± 2.12, respectively). The area under the receiver operating characteristic curve (AUC) for the SOFA score is 0.897 [95% confidence interval (CI) = 0.830-0.964] for 30-day mortality. The SOFA score was also compared with other validated risk scores, namely, the Get With the Guidelines-Heart Failure (GWTG-HF) risk score and the Acute Decompensated Heart Failure National Registry (ADHERE) score. In this study cohort, the SOFA score demonstrates superior predictive accuracy to the GWTG-HF and ADHERE scores [the AUCs when predicting 30-day mortality are 0.769 (95% CI = 0.676-0.862) and 0.789 (95% CI = 0.705-0.873), respectively]. CONCLUSION: The SOFA score might be used to screen high-risk patients for optimization strategy in the treatment of ADHF.