Positioning the role of qSOFA for screening and prognostication in critically ill medical and surgical patients with suspected sepsis

Abstract

The global magnitude of sepsis coupled with the unacceptably high attendant mortality continues to fuel universal efforts to improve its early detection and the assessment of severity of disease in the pursuit of improving clinical outcomes. The quick Sequential Organ Failure Assessment (qSOFA) score was introduced in conjunction with the Sepsis-3 definition – the intention being that a positive qSOFA score would serve as a screening tool for sepsis and for predicting poor outcomes in such patients. The qSOFA score is based on three variables: a Glasgow Coma Score <15, a respiratory rate ≥22 breaths per minute, and a systolic blood pressure ≤100 mmHg. The simultaneous presence of two of these variables indicates a positive qSOFA. There is no directive on how to gauge change in mentation at baseline for patients with altered mental status. The appeal of qSOFA score is related to it being immediately calculated without additional investigations and the ease of its derivation.