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Quick Sequential Organ Failure Assessment - Rapid sepsis screening at bedside
Glasgow Coma Scale <15 or any acute change in mental status
○ Negative - RR <22 breaths/min
○ Negative - SBP >100 mmHg
In-Hospital Mortality:
Low risk for sepsis-related adverse outcomes. Continue routine monitoring if infection suspected.
qSOFA ≥2 suggests high-risk sepsis. Screen for infection, calculate full SOFA score, and initiate appropriate interventions. Not diagnostic - use alongside clinical judgment.
qSOFA is a screening tool for outside the ICU. A score ≥2 prompts further investigation for organ dysfunction and sepsis, not a sepsis diagnosis.
| Feature | qSOFA | SOFA |
|---|---|---|
| Purpose | Bedside sepsis screening | Quantify organ dysfunction |
| Setting | Outside ICU (ED, ward) | ICU and critically ill patients |
| Variables | 3 clinical criteria | 6 organ systems with labs |
| Score Range | 0-3 points | 0-24 points |
| Time to Calculate | Seconds (bedside) | Minutes (requires labs) |
| Labs Required | None | Yes (platelets, bilirubin, creatinine) |
| Threshold | ≥2 indicates high risk | Increase ≥2 defines sepsis |
| Use Case | Early identification, triage | Diagnosis, tracking, severity |
Quick bedside assessment without labs. Identifies patients needing urgent evaluation for sepsis and organ dysfunction. Takes seconds to calculate.
Triages patients with suspected infection. qSOFA ≥2 prompts sepsis workup, lactate measurement, and expedited care. Aids in disposition decisions.
Monitors hospitalized patients with infection. Increasing qSOFA triggers escalation to higher level of care and full SOFA assessment.
No laboratory tests required. Useful where lab turnaround is slow or unavailable. Guides early recognition and treatment initiation.
qSOFA is a screening tool, not a diagnostic criterion for sepsis. Requires clinical context, suspected infection, and should prompt full SOFA calculation.
May miss sepsis cases that don't meet criteria. Should not replace clinical suspicion. Use alongside other assessments and biomarkers.
qSOFA ≥2 has high specificity for adverse outcomes. More specific than SIRS but less sensitive than lactate or full SOFA for sepsis identification.
Designed for non-ICU settings. In ICU, use full SOFA score. qSOFA not validated or recommended for ICU sepsis screening or monitoring.
qSOFA (quick SOFA) is a simplified 3-point bedside screening tool for identifying patients at high risk for poor outcomes outside the ICU. It uses altered mental status, respiratory rate ≥22, and systolic BP ≤100. Unlike full SOFA which requires 6 organ systems and laboratory values, qSOFA can be calculated in seconds without labs, making it ideal for rapid screening in emergency departments and general wards.
No. qSOFA ≥2 indicates a patient with suspected infection is at high risk for adverse outcomes and should prompt further evaluation for sepsis, including full SOFA score calculation. Sepsis diagnosis requires evidence of infection plus acute organ dysfunction (SOFA increase ≥2). qSOFA is a screening tool that triggers more comprehensive assessment, not a diagnostic criterion itself.
qSOFA replaced SIRS in Sepsis-3 definitions for outside-ICU screening because it better predicts mortality and ICU admission. SIRS has poor specificity - many non-septic conditions trigger SIRS. qSOFA ≥2 has higher specificity for identifying patients at risk for poor outcomes, though SIRS may be more sensitive. Use qSOFA for rapid risk stratification in suspected infection.
No. qSOFA was specifically developed and validated for use outside the ICU. In critically ill ICU patients, use the full SOFA score for assessing organ dysfunction and sepsis. ICU patients often have baseline abnormalities in qSOFA parameters, reducing its discriminatory ability. Full SOFA provides more granular assessment of organ dysfunction severity in this population.
Trust clinical judgment. qSOFA has lower sensitivity and may miss sepsis cases. If clinical suspicion remains high, proceed with sepsis workup including lactate, blood cultures, full SOFA score, and consider early antibiotics. qSOFA is a screening tool to aid decision-making, not a rule-out test. Never let a low qSOFA delay appropriate sepsis treatment when clinically indicated.
Altered mental status in qSOFA means Glasgow Coma Scale (GCS) <15 or any acute change from baseline mental status. This includes confusion, disorientation, decreased responsiveness, agitation, or somnolence. Document baseline mental status if known. New or acutely worsening confusion, even with GCS 15, should raise concern and may warrant qSOFA positivity.
qSOFA was derived and validated in the Sepsis-3 task force analysis of >150,000 patients. Outside ICU, qSOFA ≥2 predicted mortality and prolonged ICU stay better than SIRS ≥2. Subsequent studies show mixed results - qSOFA has excellent specificity but lower sensitivity compared to lactate and full SOFA. Best used as rapid screening trigger for further evaluation, not standalone diagnostic tool.
qSOFA was introduced in the 2016 Sepsis-3 definitions as a bedside screening tool for sepsis outside ICU. It replaced SIRS criteria in the clinical definition. The three simple criteria can be rapidly assessed without laboratory tests, enabling quick identification of high-risk patients.
qSOFA ≥2 has specificity around 90% but sensitivity only 50-60% for sepsis mortality. This means it accurately identifies high-risk patients but misses many sepsis cases. Trade-off favors specificity for screening tool - positive result demands action, while negative doesn't exclude sepsis.
Use qSOFA as rapid screening in patients with suspected infection. Score ≥2 triggers comprehensive sepsis evaluation including full SOFA, lactate, cultures, and bundle initiation. Combine with clinical judgment, biomarkers, and serial assessments. Low threshold for treatment when sepsis suspected regardless of qSOFA.
This qSOFA calculator is for educational and informational purposes only. It is a screening tool, not a diagnostic test for sepsis. Clinical judgment should always take precedence. Low qSOFA does not rule out sepsis. Always consider full clinical picture and consult qualified healthcare providers for patient care decisions.