qSOFA

Overview

qSOFA was introduced as part of the Sepsis-3 consensus definitions in 2016 to give clinicians a fast, bedside-only alternative to the full SOFA score for identifying patients with suspected infection who are likely to have a poor outcome. Unlike SOFA, qSOFA requires no laboratory values — only respiratory rate, mental status, and blood pressure — and can be assessed in seconds.

A qSOFA score of 2 or more is associated with a greater risk of death or prolonged ICU stay, and should prompt further investigation for organ dysfunction, escalation of care, and consideration of the full SOFA score. qSOFA is a screening tool, not a diagnostic criterion for sepsis — it does not replace clinical judgment.

Criteria

Criterion	Threshold	Points
Respiratory rate	≥ 22 breaths/min	1
Mentation	Altered (GCS < 15)	1
Systolic blood pressure	≤ 100 mmHg	1

Total score ranges from 0 to 3 points — 1 point for each criterion present.

Interpretation

Score	Meaning
0–1	Low risk — continue routine monitoring, reassess if clinical status changes
≥ 2	High risk — increased risk of mortality and prolonged ICU stay; investigate for organ dysfunction and consider escalation of care

Limitations

• Lower sensitivity than SIRS criteria or full SOFA for detecting sepsis, particularly early in its course
• Should be used as a prompt for further evaluation, not as a standalone diagnostic or exclusion criterion
• Not validated for use in isolation to withhold treatment in patients with clinically suspected infection

Literature

Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):762–774.

Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.