qSOFA Score in Septic Patients

The qSOFA score was developed through the Sepsis III Guidelines (Singer et al. 2016) to identify patients at higher risk for mortality from their suspected infection. Notably, it is not a diagnostic tool for identifying septic patients themselves.

The 3^rd International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) (Singer et al. 2016) updated previous definitions for sepsis with the objective of being more consistent with the pathophysiology and modern understanding of the disease process. The derivation of study involved a retrospective examination of 148,907 patients with suspected infection examining for mortality traits. The qSOFA score is a bedside clinical tool that arose from this study and was subsequently validated (Seymour et al 2017). It is used for patients in out-of-hospital, emergency department, or general ward settings, and is applied for those with suspected infection.

A qSOFA score of 2 or 3 predicted a 3-14 times greater in-hospital mortality than those with a score of 1 or 0. The authors from the derivation and validation study support qSOFA as a tool for assessing mortality in patients with suspected infection, noting that clinical suspicion for infection is derived separately.

A score is assigned by the following variables.

Variable & Associated Points

• 0 points = Not high risk
• 1 point = Not high risk
• 2 points = High risk
• 3 points = High risk

Results (either):

Not high risk In patients with suspected infection, these patients are lower risk for in-hospital mortality. This does not diagnose nor rule out sepsis.

High risk In patients with suspected infection, these patients have 3-14 times higher rates of in-hospital mortality as compared to low-risk patients. This does not diagnose nor rule out sepsis.