Quick Sequential Organ Failure Assessment

A bedside sepsis-risk screen for adults with suspected or confirmed infection. It records three objective clinical criteria — respiratory rate, mentation, and systolic blood pressure — scores each as 0 or 1, sums a total of 0–3, and flags the patient as higher risk of a poor outcome when the score is ≥ 2. A high score is not a diagnosis of sepsis; it is a prompt to escalate: perform a full Sequential Organ Failure Assessment (SOFA), start a sepsis workup, and obtain senior review.

qSOFA is the "quick" variant of the SOFA score introduced by the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3, Singer et al., JAMA 2016). It was designed to identify, without laboratory tests, patients with suspected infection likely to have a prolonged intensive-care stay or die in hospital, particularly outside the ICU.

Scoring

Three criteria, each 1 point when present: respiratory rate ≥ 22/min; Glasgow Coma Scale < 15 (altered mentation); systolic blood pressure ≤ 100 mmHg. Total 0–3. 0–1 = lower risk (continue monitoring; a low score doesn't rule out sepsis). 2–3 = higher risk (positive screen — obtain senior/critical-care review, calculate a full SOFA score, initiate a sepsis workup and management bundle).

What it covers

Assessment context (clinician, care setting, suspected infection source); patient identification; respiratory rate; mentation (GCS or alertness vs. baseline); systolic blood pressure; and a summary with the computed total, risk band, and escalation recommendation.

Relationship to sequential-organ-failure-assessment

qSOFA is a screening tool with three criteria and no laboratory tests, usable anywhere including outside the ICU; the full Sequential Organ Failure Assessment (SOFA) scores six organ systems using laboratory and physiological data (0–24 total) and is the definitive instrument a positive qSOFA screen should prompt.

Common pitfalls

• Treating a qSOFA below 2 as ruling out sepsis — it does not; the score is a screen, not an exclusionary test, and clinical suspicion should still drive further workup when present.
• Using qSOFA as a substitute for a full SOFA score in the ICU — qSOFA is deliberately simplified for settings without ready lab access; in the ICU, the full SOFA score is the appropriate instrument.
• Not re-scoring as the patient's status changes — qSOFA is meant to be repeated as the clinical picture evolves, not scored once at initial presentation.

Learn more

• Singer M. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315(8):801–810.
• FormExamples: quick-sequential-organ-failure-assessment for the full implementation and clinical references.
• Sequential Organ Failure Assessment for the full, definitive SOFA instrument this screen prompts.