π¨ qSOFA Score Calculator
Three bedside signs that flag sepsis risk.
For informational purposes only, not medical advice. Consult a healthcare professional.
The quick Sequential Organ Failure Assessment, qSOFA, distills sepsis risk into three bedside signs: fast breathing, low systolic pressure, and altered mental status. Introduced in the Sepsis-3 definitions, it was designed to flag infected patients likely to have poor outcomes using no labs and no waiting. A score of 2 or more carries roughly a three to fourteen-fold higher risk of bad outcomes than lower scores, depending on the setting. This calculator scores it for education and clinical reference.
How to Use This Calculator
Check each of the three qSOFA criteria that is present in a patient with suspected infection. The score stratifies risk of poor outcome.
Confirm suspected infection first. qSOFA screens infected patients; it is not a general early-warning score.
Check respiratory rate 22 plus, systolic 100 or less, and any altered mentation. One point each, no labs needed.
Read the total. Two or more flags high risk of prolonged ICU stay or death and should prompt escalation.
How the Math Works
One point each for respiratory rate 22 or higher, systolic blood pressure 100 mmHg or lower, and Glasgow Coma Scale under 15. The total runs 0 to 3. In the Sepsis-3 derivation and validation cohorts, qSOFA of 2 or more predicted in-hospital mortality and prolonged ICU stay far better than SIRS criteria outside the ICU. It is a prognostic screen, not a diagnostic test: it does not diagnose sepsis, it identifies infected patients whose trajectory looks dangerous. The full SOFA score, with labs, remains the diagnostic standard for organ dysfunction.
Worked Example
A patient with suspected pneumonia breathing 26 times a minute and a systolic of 95, but alert, scores 2 points. The calculator flags this as High risk: the Sepsis-3 data says this patient faces a substantially higher risk of poor outcome than a similar patient scoring 0 or 1. That flag should trigger lactate measurement, blood cultures, prompt antibiotics, and a higher level of monitoring.
Reading Your Result
Zero or 1 in suspected infection means lower predicted risk but not no risk; keep monitoring because qSOFA is a snapshot. A score of 2 or 3 means high risk: escalate care, measure lactate, draw cultures before antibiotics, and give broad-spectrum antibiotics quickly. qSOFA misses some septic patients, especially early, so a low score never overrules clinical concern. It performs best outside the ICU; inside it, the full SOFA score takes over.
| qSOFA | Risk | Action |
|---|---|---|
| 0-1 | Lower | Monitor, routine workup |
| 2-3 | High | Escalate, lactate, early antibiotics |
Limitations
qSOFA is less sensitive than SIRS for early sepsis, so it misses cases SIRS would catch; its strength is specificity and simplicity. It was validated in suspected infection and performs poorly as a general deterioration score. Mental status assessment varies between observers. It supports, never replaces, clinical judgment, and the one-hour sepsis bundle elements proceed on suspicion, not on the score.
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For informational purposes only, not medical advice. Consult a healthcare professional.
Frequently Asked Questions
What is qSOFA?
The quick Sequential Organ Failure Assessment: three bedside criteria scoring sepsis risk in suspected infection. Respiratory rate 22+, systolic BP 100 or less, and GCS under 15, one point each. Two or more points flag high risk of poor outcome. Part of the Sepsis-3 definitions from 2016.
What is the difference between qSOFA and SOFA?
qSOFA is the 3-item bedside screen needing no labs; SOFA is the full 6-organ score with labs that defines sepsis-related organ dysfunction. qSOFA prompts suspicion and escalation; SOFA confirms the organ dysfunction that defines sepsis under Sepsis-3.
Does qSOFA diagnose sepsis?
No. Sepsis-3 defines sepsis as suspected infection plus an acute SOFA increase of 2 or more. qSOFA identifies which infected patients are likeliest to deteriorate. A high qSOFA should prompt the workup that makes the diagnosis, not substitute for it.
Why was SIRS replaced?
SIRS criteria were too sensitive and nonspecific: most ICU patients meet them without infection. Sepsis-3 moved to organ dysfunction as the defining feature because it predicts mortality far better. qSOFA was built for bedside risk stratification without waiting for labs.
What should happen with a qSOFA of 2?
Treat as high risk: measure lactate, draw blood cultures, start broad-spectrum antibiotics promptly, give fluids if hypotensive, and escalate monitoring or location of care. The score is the trigger; the sepsis bundle is the response.
Is qSOFA used in the ICU?
Less so. Inside the ICU the full SOFA score is available and more informative. qSOFA was designed for emergency departments, wards, and prehospital settings where labs are pending and speed matters.
Can qSOFA miss sepsis?
Yes. Early sepsis can present with a qSOFA of 0 or 1, which is its main criticism versus SIRS. That is why guidelines stress acting on clinical suspicion regardless of score. A low qSOFA reassures; it does not clear.
What counts as altered mentation?
GCS under 15: any new confusion, disorientation, agitation, or reduced responsiveness compared with baseline. In patients with chronic cognitive impairment, compare against their usual state, not a perfect 15.
How often should qSOFA be repeated?
With each reassessment of a potentially septic patient. It is a snapshot that can worsen quickly, and trending it alongside vitals catches deterioration. Many early-warning workflows recheck it hourly in concerning cases.
Does qSOFA apply to children?
No. Pediatric sepsis uses age-adjusted criteria because vital-sign norms differ by age. Adult qSOFA cutoffs misclassify children badly. Pediatric-specific tools exist for young patients with suspected infection.