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Emergency Medicine & Critical CareqSOFA

qSOFA Score Calculator – Quick SOFA (Sepsis-3)

Calculate the original adult Sepsis-3 qSOFA prognostic prompt from respiratory rate, altered mentation, and systolic blood pressure.

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Formula and medical content are based on the references listed on this page. See sources, About, and Sources and Review Process.

qSOFA components — 1 point each

qSOFA means quick Sequential Organ Failure Assessment. It is the original three-item Sepsis-3 bedside prompt, not a shortened calculation of the six-system full SOFA score.

  • Respiratory rate
    ≥22 breaths/min
  • Altered mentation
    Present
  • Systolic BP
    ≤100 mmHg

Total: 0–3. [1, 2]

Current hospital-screening boundary: The 2026 Surviving Sepsis Campaign recommends NEWS/NEWS2, MEWS, or SIRS over qSOFA as a single tool to screen acutely ill patients in hospital. qSOFA is not a sepsis diagnosis or exclusion test. [5]

Assessment scope and data quality

Use qSOFA in its original adult known or suspected infection context. The calculator cannot verify infection and is not a general score for any hypotensive or tachypneic patient.

Use clinically contemporaneous RR, SBP, and mentation from one assessment context. This is QuickMedCalc data-quality guidance, not an added same-minute Sepsis-3 criterion; the site cannot verify timestamps or encounter provenance.

Adult qSOFA assessment values

Enter breaths/min from the assessment context.

Enter mmHg from the assessment context.

Sepsis-3 uses altered mentation, explained as any GCS <15. The page records an external assessment; it does not perform GCS. Sedation, intubation, paralysis, intoxication, post-ictal state, hearing/language barriers, dementia, or baseline neurologic impairment can make this not assessable.

About

qSOFA means quick Sequential Organ Failure Assessment. This page calculates the original three-item Sepsis-3 adult prognostic prompt from respiratory rate, systolic blood pressure, and altered mentation. The result is a 0–3 score with the original ≥2 prompt threshold; it records an external mentation assessment and does not perform a GCS examination. [1, 2]

Use qSOFA in its original adult known or suspected infection context, especially outside the ICU. Use clinically contemporaneous RR, SBP, and mentation from one assessment context. That pairing is a QuickMedCalc data-quality convention—not an added same-minute Sepsis-3 criterion—and the site cannot verify infection, timestamps, or encounter provenance. qSOFA is not validated here as a general score for any hypotensive or tachypneic patient, and it is not a pediatric score. [1, 2, 7]

qSOFA does not define, diagnose, stage, or exclude sepsis, and it does not diagnose septic shock or provide a personal mortality probability. This page does not calculate full SOFA, SIRS, NEWS/NEWS2, MEWS, modified qSOFA, or Phoenix, and it does not choose antibiotics, cultures, lactate testing, fluids, vasoactive medicines, ICU care, referral, or monitoring frequency. [2, 5, 6, 7]

Formula

Adult qSOFA total = RR criterion + SBP criterion + altered-mentation criterion (0–3). [1, 2]
RR criterion = 1 when respiratory rate ≥22 breaths/min; SBP criterion = 1 when systolic blood pressure ≤100 mmHg. [1, 2]
Altered mentation = 1 when the external assessment is present; not assessable produces no total or threshold. Original ≥2 is a prognostic prompt, not a sepsis diagnosis. The page provides no individual mortality probability and no antibiotic, fluid, vasopressor, ICU, referral, or other treatment recommendation. [1, 2, 5]

Interpretation

Output
qSOFA Score
Formal range/state
0–3
Meaning
Three-item prognostic prompt total
What it does not mean
Not a sepsis diagnosis
Output
Original ≥2 prompt
Formal range/state
Met / not met
Meaning
Original further-assessment prompt state
What it does not mean
Not a treatment or ICU instruction
Output
Altered mentation
Formal range/state
Present / absent / not assessable
Meaning
External assessment category
What it does not mean
Not a page-performed GCS examination
Output
Assessment provenance
Formal range/state
Clinically contemporaneous observations
Meaning
QuickMedCalc data-quality guidance
What it does not mean
Not an added same-minute Sepsis-3 criterion

Sepsis-3 operationalization uses suspected infection plus an acute full-SOFA increase of at least 2; qSOFA is not that definition. Scores ≥2 were associated with poorer outcomes in the original prognostic work, while a score below 2 cannot exclude sepsis, organ dysfunction, or deterioration. This page does not provide dynamic low/high-risk labels or a personal mortality estimate. [1, 2, 3]

Adult qSOFA criteria, model boundaries, and current screening context

Formal three-item qSOFA criteria

Each adult criterion contributes one point: respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mmHg, or altered mentation. Exact 22 and 100 values are included; 21.9 and 100.1 are not. [1, 2]

Criterion
Respiratory rate
One-point definition
≥22 breaths/min
Exact boundary
22 is included; 21.9 is not
Page input
Positive ordinary decimal
Limitation
Records the submitted vital sign; it does not measure the patient.
Criterion
Systolic blood pressure
One-point definition
≤100 mmHg
Exact boundary
100 is included; 100.1 is not
Page input
Positive ordinary decimal
Limitation
Treatment, vasoactive support, and clinical context can affect interpretation.
Criterion
Altered mentation
One-point definition
Altered mentation
Exact boundary
Sepsis-3 bedside wording; GCS <15 is its stated explanation
Page input
External present/absent/not-assessable assessment
Limitation
The page does not perform or reconstruct a GCS examination.

Altered mentation and assessability

The derivation model used GCS ≤13 for its mental-status variable, while a sensitivity analysis used the simpler any altered mentation approach represented by GCS <15 without a significant change in prognostic performance. Sepsis-3’s final bedside qSOFA wording is altered mentation, explained as any GCS <15. This page records an already completed external assessment and cannot verify or reconstruct it. Sedation, intubation, neuromuscular blockade, intoxication, post-ictal state, hearing or language barriers, dementia, baseline cognitive impairment, and prior neurologic disease can make it unreliable. Choose Not assessable rather than silently treating uncertainty as absent. [1, 2]

Adult infection context and assessment provenance

qSOFA was developed as a bedside prognostic prompt in adults with known or suspected infection, especially outside the ICU. The calculator cannot verify infection and should not be detached from that scope. Use clinically contemporaneous respiratory rate, systolic pressure, and mentation from one assessment context. This is a QuickMedCalc data-quality convention: Sepsis-3 does not define an added same-minute confirmation criterion, and the site cannot verify timestamps or whether observations came from the same encounter. [1, 2]

What this calculator actually does

  1. Reads respiratory rate, systolic blood pressure, and an external mentation assessment.
  2. Applies the three fixed criteria and, only when all are assessable, reports 0–3 and the original ≥2 state.
  3. Withholds the total when mentation is not assessable and retains a three-row audit.

It does not diagnose infection, sepsis, or septic shock; read GCS, monitor vital signs, calculate full SOFA, or select testing, treatment, or care location. It implements no modified-qSOFA variant or mnemonic-driven score.

qSOFA, full SOFA, SIRS, NEWS/NEWS2, and MEWS

These frameworks have different variables, weights, time windows, and purposes and their scores cannot be converted. The 2026 Surviving Sepsis Campaign recommends NEWS, NEWS2, MEWS, or SIRS rather than qSOFA alone for screening hospitalized acutely ill adults. [2, 5]

Framework
qSOFA
Inputs
RR, SBP, altered mentation
Main use
Short adult prognostic prompt
Current boundary
0–3; original ≥2 prompt
Why not interchangeable
It is not full organ-function assessment or a sepsis definition.
Framework
Full SOFA
Inputs
Six organ systems
Main use
Organ dysfunction operationalization and serial assessment
Current boundary
An acute increase of ≥2 is part of Sepsis-3
Why not interchangeable
Different inputs, scale, and clinical task.
Framework
SIRS
Inputs
Temperature, heart rate, respiratory rate/PaCO₂, WBC
Main use
Different systemic-response framework
Current boundary
Not a qSOFA conversion
Why not interchangeable
Different variables and intended use.
Framework
NEWS/NEWS2
Inputs
Early-warning vital-sign and oxygenation inputs
Main use
Acute deterioration early warning
Current boundary
2026 SSC prefers it over qSOFA alone for hospitalized acutely ill adults
Why not interchangeable
Different weighted system and response pathway.
Framework
MEWS
Inputs
Early-warning physiologic inputs
Main use
Acute deterioration early warning
Current boundary
2026 SSC names it among preferred single screening tools
Why not interchangeable
Not equivalent to qSOFA points or Sepsis-3 SOFA.

Prognostic performance and setting limitations

Fernando’s systematic review and meta-analysis included 38 studies and 385,333 people and reported pooled mortality sensitivity of 60.8% and specificity of 72.0%. Those are population-level estimates, not an individual probability and not an exclusion rule. In ICU adults with suspected infection, Raith found full SOFA had better prognostic discrimination than qSOFA. [3, 4]

Sepsis, septic shock, and qSOFA

qSOFA is a prognostic prompt, sepsis is a clinical diagnosis with an organ-dysfunction framework, and septic shock has separate circulatory and metabolic criteria. A qSOFA score cannot diagnose either sepsis or septic shock. [2, 5, 6]

Concept
qSOFA
What it requires
Three adult bedside criteria in a known or suspected infection context
What this page does
Calculates the original 0–3 prognostic prompt only
Concept
Sepsis
What it requires
Clinical infection plus life-threatening organ dysfunction; Sepsis-3 uses an acute full-SOFA increase ≥2
What this page does
Does not diagnose, confirm, or exclude sepsis
Concept
Septic shock
What it requires
Separate clinical and circulatory/metabolic criteria
What this page does
Does not diagnose shock or select treatment

Adult and pediatric boundary

This page is restricted to adult qSOFA. Phoenix Sepsis Criteria are a separate pediatric framework; the page does not apply fixed adult criteria to children and does not calculate the 2024 Phoenix pediatric sepsis and septic-shock framework, which is not an early-screening substitute. [7]

Worked examples from the implementation

  • RR 21.9, SBP 100.1, altered mentation absent → score 0; the original ≥2 prompt is not met, but a score below 2 cannot exclude sepsis or deterioration.
  • At the exact boundaries RR 22 and SBP 100 with altered mentation absent → score 2; the original prompt is met, not a sepsis diagnosis.
  • RR 22, SBP 100, altered mentation present → score 3; the page gives no personal mortality probability, risk color, or treatment recommendation.
  • Decimal comparisons use the exact submitted values before display formatting, so values such as RR 21.999999999999999999 remain below 22 and RR 22.000000000000000001 remains at or above 22.
  • RR 22, SBP 120, and altered mentation not assessable → no total or result card; the unavailable state does not show a partial score or prompt state.
  • RR, SBP, and mentation should be clinically contemporaneous. That is data-quality guidance, not an added same-minute qSOFA criterion.

Examples show calculator arithmetic only; none is a diagnosis, personal risk estimate, or treatment instruction. [1, 2]

Current 2026 screening context

The 2026 Surviving Sepsis Campaign recommends NEWS, NEWS2, MEWS, or SIRS rather than qSOFA alone as a single screening tool for hospitalized acutely ill adults. No single score, biomarker, or test independently confirms or excludes sepsis. This page preserves qSOFA’s original prompt as historical/model-specific context and does not rebrand it as the current universal screen. [5]

Important limitations

  • This adult prompt is not validated here for children or pregnancy, and non-infection contexts are outside its intended scope. qSOFA does not replace continuous clinical assessment or an ICU assessment pathway.
  • Mechanical ventilation, intubation, oxygen therapy, sedation, neuromuscular blockade or paralysis, vasoactive therapy, prior fluids or other treatment, and respiratory support can alter observations or assessability.
  • Intoxication, seizure or post-ictal state, dementia, delirium, baseline neurologic impairment, hearing or language barriers, and measurement error can affect altered-mentation assessment.
  • Manual respiratory-rate measurement error, cuff-versus-arterial systolic-pressure differences, rapidly changing physiology, mismatched assessment timepoints, and incomplete organ assessment can change interpretation. Delayed deterioration remains possible.
  • A score of 0 or 1 does not mean safe, and a score of 2 or 3 does not mean sepsis. Do not wait for an online calculator when a patient is unstable; use complete clinical assessment, serial organ-function review, and local screening pathways.
  • Do not infer antibiotics, fluids, cultures, lactate, ICU placement, referral, monitoring, or other treatment from the score.

qSOFA does not replace continuous clinical assessment, and an unstable patient must not wait for an online calculator. The page does not read records or devices, and calculator inputs and results remain outside URLs, storage, analytics, advertising, and network payloads. [1, 2, 4, 5, 7]

References

  1. 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. JAMA. 2016;315(8):762–774. PMID 26903335. PMCID PMC5433435. DOI 10.1001/jama.2016.0288.
  2. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock. JAMA. 2016;315(8):801–810. PMID 26903338. PMCID PMC4968574. DOI 10.1001/jama.2016.0287.
  3. Fernando SM, Tran A, Taljaard M, et al. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection: A Systematic Review and Meta-analysis. Ann Intern Med. 2018;168(4):266–275. PMID 29404582. DOI 10.7326/M17-2820.
  4. Raith EP, Udy AA, Bailey M, et al. Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit. JAMA. 2017;317(3):290–300. PMID 28114553. DOI 10.1001/jama.2016.20328.
  5. Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):725–812. PMID 41869847. DOI 10.1097/CCM.0000000000007075. Parallel publication: Intensive Care Med. 2026;52(5):863–936. PMID 41870560. DOI 10.1007/s00134-026-08361-1.
  6. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock. JAMA. 2016;315(8):775–787. PMID 26903336. PMCID PMC4910392. DOI 10.1001/jama.2016.0289.
  7. Schlapbach LJ, Watson RS, Sorce LR, et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024;331(8):665–674. PMID 38245889. DOI 10.1001/jama.2024.0179.

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Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.