qSOFA (Quick SOFA)
Bedside sepsis screening tool — no lab tests required
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Why use it
Rapid bedside screening for sepsis risk — no labs needed. Identifies patients who need further assessment with full SOFA score. Designed for use outside the ICU (ED, wards, pre-hospital).
About
Quick SOFA (qSOFA) is a bedside screening tool introduced with the Sepsis-3 definitions. It identifies patients with suspected infection who are at risk for poor outcomes (ICU admission or death). It requires no laboratory tests and uses only three clinical criteria: altered mentation, respiratory rate ≥ 22, and systolic BP ≤ 100.
When to use
- Suspected infection on general wards or in ED
- Bedside screening when lab results are not yet available
- Triage tool to identify patients needing ICU-level assessment
Formula
Pearls & pitfalls
- qSOFA is a SCREENING tool, not a diagnostic criterion for sepsis.
- qSOFA ≥ 2 does NOT equal sepsis — it identifies patients needing further evaluation.
- Sensitivity for sepsis is moderate — do NOT use qSOFA alone to rule out sepsis.
- Most useful outside the ICU; inside ICU, use full SOFA score.
- Altered mentation = GCS < 15 (any new change from baseline).
Next steps
qSOFA ≥ 2: Assess for organ dysfunction with full SOFA score. Consider lactate measurement. Initiate sepsis bundle if sepsis confirmed. qSOFA < 2 does NOT exclude sepsis — maintain clinical vigilance.
Evidence
Derived from Sepsis-3 consensus (Seymour et al., JAMA 2016). qSOFA ≥ 2 associated with 3-14× higher in-hospital mortality in patients with suspected infection. Criticized for low sensitivity (~50%) — should not replace clinical judgment.