qSOFA

qSOFA, or quick Sequential Organ Failure Assessment, is a brief bedside tool intended to identify adult patients with suspected infection who are at higher risk of poor outcome, particularly outside the intensive care setting. It was introduced as part of the Sepsis-3 definitions by Singer and colleagues in 2016.

The qSOFA score uses three criteria: respiratory rate of 22 breaths per minute or higher, altered mentation, and systolic blood pressure of 100 mmHg or less. Altered mentation is defined as any change from baseline mental status or a Glasgow Coma Scale score below 15. Each criterion scores 1 point, yielding a total score from 0 to 3.

A qSOFA score of 2 or more suggests an increased risk of sepsis-related mortality and prompts further assessment for organ dysfunction, including consideration of a full SOFA score and appropriate management. It is intended as a prompt for evaluation rather than a diagnostic test for sepsis.

Use and limitations: qSOFA is designed for rapid assessment in settings like emergency departments or during prehospital care and is not intended to diagnose sepsis by itself. Its sensitivity to detect sepsis or predict mortality is lower than other approaches such as SIRS or the full SOFA score, and it may miss early cases. It is not routinely recommended for children, where pediatric-specific scores (pSOFA) or other tools are used. Clinicians should integrate qSOFA with clinical judgment and other assessments rather than relying on it in isolation.