Your qSOFA score ranges from 0 to 3 based on three bedside criteria: systolic blood pressure 100 mmHg or below, respiratory rate 22 or above, and altered mentation (GCS below 15). A score of 0 or 1 suggests lower risk of poor outcomes from infection, though it does not rule out sepsis. Standard monitoring and clinical reassessment should continue.

A qSOFA score of 2 or 3 identifies patients with suspected infection who are at significantly higher risk of prolonged ICU stay or in-hospital death. This should prompt immediate action: obtain blood cultures and lactate, administer broad-spectrum antibiotics within one hour, initiate fluid resuscitation if hypotensive, and assess for organ dysfunction using the full SOFA score. Early recognition and treatment of sepsis are strongly associated with improved survival.

It is important to understand that qSOFA is a risk stratification tool, not a diagnostic test for sepsis. A positive qSOFA (score of 2 or more) identifies patients who need urgent attention, but the definitive diagnosis of sepsis under Sepsis-3 criteria requires evidence of organ dysfunction as measured by a SOFA score increase of 2 or more points in the setting of suspected infection.

The qSOFA should be used as a rapid bedside screening tool for patients with suspected or confirmed infection who are outside the ICU — particularly on general medical and surgical wards, in the emergency department, and in urgent care settings. It is designed to quickly identify patients who may be developing sepsis and who need escalation of care, without waiting for laboratory results.

qSOFA is particularly useful in resource-limited settings or time-critical situations where laboratory values are not immediately available. It can be assessed in under one minute using only a blood pressure cuff, observation of respiratory rate, and a brief mental status assessment. It should be used as a trigger for further evaluation, not as a replacement for clinical judgment or comprehensive sepsis assessment.

The qSOFA has higher specificity but lower sensitivity compared to the older SIRS criteria for identifying sepsis. This means that while a positive qSOFA reliably identifies high-risk patients, a negative qSOFA (score of 0 or 1) does not rule out sepsis. Some patients with serious infections and organ dysfunction will have a qSOFA of 0 or 1 and may be missed if qSOFA is used as the sole screening tool.

qSOFA was derived and validated primarily in adult patients and should not be applied to pediatric populations without modification. It was also designed for use outside the ICU — in ICU patients, the full SOFA score is more appropriate because these patients are already receiving intensive monitoring and may have qSOFA abnormalities from non-infectious causes.

The three qSOFA criteria can be abnormal for many reasons other than sepsis, including pain, anxiety, neurological conditions, respiratory disease, and medication effects. A positive qSOFA in a patient with a known alternative explanation for these findings should still prompt consideration of infection, but clinical context is essential. Some professional societies have expressed concern that qSOFA may delay recognition of sepsis compared to SIRS-based screening, and institutional protocols should be followed.