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qSOFA (Quick SOFA) Score for Sepsis
Identifies high-risk patients for in-hospital mortality with suspected infection outside the ICU.
Use to predict mortality, NOT to diagnose sepsis, per 2021 Surviving Sepsis Guidelines.
When To Use
Patients ≥18 years old in a non-ICU setting (i.e. pre-hospital, ward, emergency department, or step-down unit) with confirmed or suspected infection.
Clinical Advice
- A “positive" qSOFA Score (≥2) suggests high risk of poor outcome in patients with suspected infection. These patients should be more thoroughly assessed for evidence of organ dysfunction.
- A positive qSOFA Score by itself should not trigger sepsis-directed interventions like initiation of broad-spectrum antibiotics; rather, it should prompt clinicians to further investigate for presence of organ dysfunction or to increase frequency of monitoring.
- The Sepsis-3 task force recommends that a positive qSOFA Score should prompt the calculation of a SOFA score to confirm the diagnosis of sepsis. This remains controversial, as qSOFA has been shown to be more predictive than SOFA outside of the ICU setting.
- Even if the qSOFA Score is initially "negative" (<2), it can be repeated if there is a change in the patient’s clinical status.
Management
- qSOFA is a mortality predictor, NOT a diagnostic test for sepsis. It is still not clear how it will be used in the sequence of events going from screening, to diagnosis of sepsis, to the triggering of sepsis-related interventions.
- The management of sepsis is continually evolving and is detailed in the Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Additional Information
Interpretation:
|
qSOFA Score |
Risk group |
|
0-1 |
Not high risk for in-hospital mortality |
|
2-3 |
High risk for in-hospital mortality (3- to 14-fold increase) |