Medical AIqSOFA sepsis risk calculator
Three rapidly-assessed criteria identify patients with suspected infection who are at higher risk of in-hospital death or prolonged ICU stay. A score of 2 or more should prompt escalation, lactate measurement, and a full sepsis assessment. qSOFA is a prompt, not a diagnosis of sepsis and not a screening replacement.
How to measure each input
- Respiratory rate
- Count over a full 60 seconds at rest. Brief 15-second counts overestimate at the high end, where this criterion sits.
- Mentation
- Any new alteration from baseline counts. The Sepsis-3 definition uses a Glasgow Coma Scale below 15, so a patient who is not fully alert and oriented scores the point.
- Systolic blood pressure
- Use systolic BP at or below 100 mmHg. Note this threshold is higher (less extreme) than the 90 mmHg often used elsewhere.
Interpretation
| Band | Meaning |
|---|---|
| 0 to 1, lower risk | Lower risk of poor outcome from suspected infection. This does not exclude sepsis: reassess if the clinical picture worsens, and remember qSOFA is less sensitive than SIRS or NEWS2 for early screening. |
| >= 2, higher risk | Associated with markedly higher in-hospital mortality and prolonged ICU stay in suspected infection. Escalate care, measure lactate, obtain cultures, and start a full sepsis assessment and the relevant care bundle without delay. |
Pitfalls, exclusions and caveats
- qSOFA is a prompt, not a diagnosis. A score of 2 or more raises concern for poor outcome; it does not by itself diagnose sepsis or define organ dysfunction.
- It is not a screening replacement. The Surviving Sepsis Campaign recommends against using qSOFA as the single screening tool; SIRS, NEWS2, or MEWS are more sensitive for picking up sepsis early.
- A score below 2 does not exclude sepsis. Patients with infection and a low qSOFA can still deteriorate, so continue to reassess.
- Mentation and blood pressure can be confounded by sedation, intoxication, chronic hypotension, or baseline cognitive impairment.
- qSOFA was derived in adults with suspected infection and is not validated in children or pregnancy.
1 point each: respiratory rate >= 22 breaths/min + altered mentation (Glasgow Coma Scale < 15) + systolic blood pressure <= 100 mmHg. Total 0 to 3. A score >= 2 marks higher risk.qSOFA was introduced with the Sepsis-3 consensus definitions (Singer et al., 2016; Seymour et al., 2016). This implementation is an educational tool and is not affiliated with the consensus task force or any guideline body.
Frequently asked
What does a qSOFA score of 2 mean?
A score of 2 or more in a patient with suspected infection marks a substantially higher risk of in-hospital death or prolonged ICU stay. It should prompt escalation, lactate measurement, cultures, and a full sepsis assessment, but it is not itself a diagnosis of sepsis.
Should I use qSOFA to screen for sepsis?
No. The Surviving Sepsis Campaign recommends against qSOFA as the sole screening tool because it is relatively insensitive early. Use SIRS, NEWS2, or MEWS to screen, and treat qSOFA as a prompt to escalate.
How does qSOFA differ from the full SOFA score?
The full SOFA score grades organ dysfunction across six systems using labs and support requirements and defines sepsis in Sepsis-3. qSOFA is a three-item bedside surrogate that needs no labs and only flags higher-risk patients.
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