For healthcare professionals
qSOFA score calculator
qSOFA (quick Sequential Organ Failure Assessment) is a bedside prompt from the Sepsis-3 consensus. In adults with suspected infection, it counts three findings: a fast respiratory rate, altered mentation and low systolic blood pressure. Two or more flags a patient as more likely to have poor outcomes typical of sepsis. This calculator is written for clinicians and is not a diagnosis of sepsis.
Bedside findings
For adults with suspected infection. Nothing you enter leaves this page.
What you will see
The qSOFA score from 0 to 3, which criteria are met, and whether the score reaches the published threshold of 2 or more.
Educational only, not medical advice. Not a diagnosis. Sepsis is defined by organ dysfunction caused by infection, not by this score.
Source
Singer M et al., JAMA 2016 (Sepsis-3 consensus definitions), Box 4, for the three criteria and the threshold of 2 or more; Seymour CW et al., JAMA 2016, for the derivation (1 point each, range 0 to 3). The tests check each cut point and the threshold.
Validated in
Derived in adult hospital encounters with suspected infection at 12 hospitals in southwestern Pennsylvania (UPMC, 2010 to 2012; 148,907 encounters), and checked in 4 further data sets of 706,399 out-of-hospital and hospital encounters at 165 US and non-US hospitals, including Kaiser Permanente Northern California, the Veterans Administration and King County Emergency Medical Services (Seymour 2016).
Limits
qSOFA predicts poor outcome (death in hospital or a long ICU stay); it does not define sepsis, which needs an acute rise of 2 or more SOFA points due to infection. It performed worse inside the ICU than outside it. A score under 2 does not exclude sepsis. The Surviving Sepsis Campaign 2021 guideline recommends against using qSOFA as a single screening tool. Adults only.
qSOFA criteria
Score 1 point for each criterion present, for a total from 0 to 3. A score of 2 or more identifies adults with suspected infection who are more likely to have poor outcomes typical of sepsis (Singer 2016) (Seymour 2016).
| Criterion | Points |
|---|---|
| Respiratory rate 22 per minute or more | 1 |
| Altered mentation | 1 |
| Systolic blood pressure 100 mm Hg or less | 1 |
Source: Box 4 of the Sepsis-3 consensus paper (Singer 2016). In the derivation study the mentation item was a Glasgow Coma Scale score of 13 or less (Seymour 2016). The task force chose the simpler "altered mentation" (any Glasgow Coma Scale score below 15) because predictive validity did not change (Singer 2016).
What the derivation study found
Outside the ICU, qSOFA predicted in-hospital death about as well as the full SOFA score (area under the curve 0.81, 95% CI 0.80 to 0.82, in the validation cohort). Compared with a score under 2, a score of 2 or more went with a 3- to 14-fold higher hospital mortality across levels of baseline risk (Seymour 2016). Inside the ICU its discrimination was lower (area under the curve 0.66), and the SOFA score performed better there (Seymour 2016). Most encounters with infection (73% to 90%) scored under 2 (Seymour 2016).
How it is meant to be used
The Sepsis-3 task force described qSOFA as a prompt: a positive score should lead clinicians to look further for organ dysfunction, start or escalate therapy as appropriate, and consider critical care referral or more frequent monitoring. They also suggested a positive score should raise the possibility of infection in patients not yet known to be infected (Singer 2016).
qSOFA is not a screening test for sepsis. The 2021 Surviving Sepsis Campaign guideline gives a strong recommendation, based on moderate-quality evidence, against using qSOFA instead of SIRS, NEWS or MEWS as a single screening tool for sepsis or septic shock (Evans 2021).
Related tools
To grade organ dysfunction across six systems, as Sepsis-3 does, use the SOFA score calculator. To score level of consciousness in detail, use the Glasgow Coma Scale calculator. For pneumonia severity, see the CURB-65 calculator, which also uses confusion, respiratory rate and blood pressure. For a sore throat, the Centor score calculator estimates the chance of strep throat. For other clinician scores on this site, see the HEART score calculator for chest pain, the Wells score for PE the MELD score calculator and, for suspected appendicitis, the Alvarado score calculator.
Sources
- Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287. PMID 26903338. Abstract (SOFA-based definitions of sepsis and septic shock), Box 4 (qSOFA criteria) and section on screening for patients likely to have sepsis. pmc.ncbi.nlm.nih.gov/articles/PMC4968574/
- Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288. PMID 26903335. Abstract, Methods, Results and Table 4 (qSOFA model). pmc.ncbi.nlm.nih.gov/articles/PMC5433435/
- Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-y. PMID 34599691. Recommendation 2 (screening) and rationale. pmc.ncbi.nlm.nih.gov/articles/PMC8486643/
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