How it's calculated
qSOFA scores 1 point each for a raised respiratory rate, altered mentation, and low systolic blood pressure, for a total of 0-3. A score of 2 or more, in a patient with suspected infection, is associated with a substantially higher risk of in-hospital mortality and a longer ICU stay.
qSOFA criteria
| Criterion | Threshold |
|---|---|
| Respiratory rate | ≥ 22/min |
| Mentation | Altered (GCS < 15) |
| Systolic blood pressure | ≤ 100 mmHg |
Clinical use
- qSOFA is designed as a quick bedside prompt outside the ICU (ward, emergency department) to identify patients with suspected infection who may be developing sepsis — it is not itself a diagnostic criterion for sepsis.
- A qSOFA score of 2 or more should trigger further assessment for organ dysfunction — typically the full SOFA score, lactate measurement, blood cultures, and escalation of care per local sepsis protocols.
- A low qSOFA score does NOT rule out sepsis — it has lower sensitivity than SIRS criteria for detecting sepsis, so ongoing clinical concern should still prompt further assessment regardless of the score.
- qSOFA does not replace clinical judgement or the need to treat suspected sepsis promptly (cultures, fluids, antibiotics within the first hour) once suspected, regardless of the calculated score.
Frequently asked questions
What does qSOFA stand for?
Quick Sequential (Sepsis-related) Organ Failure Assessment — a fast bedside tool using three simple criteria to flag patients with suspected infection who may have a higher risk of poor outcomes.
What does a qSOFA score of 2 mean?
It flags a substantially increased risk of in-hospital death and a longer ICU stay in a patient with suspected infection, and should prompt further assessment — such as the full SOFA score, lactate, and escalation of care per sepsis protocols.
Does a low qSOFA score mean a patient doesn't have sepsis?
No — qSOFA has lower sensitivity than older screening tools (like SIRS) for detecting sepsis, so a low score should not be used to rule out sepsis if there is ongoing clinical concern for infection with organ dysfunction.
Is qSOFA the same as the full SOFA score?
No — qSOFA is a simplified 3-criterion bedside screen usable without laboratory results, while the full SOFA score assesses six organ systems using laboratory and physiological data and is used for ongoing severity tracking, typically in the ICU.
References
- Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801-810.
- Seymour CW, et al. Assessment of Clinical Criteria for Sepsis. JAMA. 2016;315:762-774.
- Surviving Sepsis Campaign. International Guidelines for Management of Sepsis and Septic Shock.