Adult qSOFA Calculator (Sepsis-3)

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]

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]

Infection context and conservative data pairing

qSOFA was developed in adults with known or suspected infection; this checkbox does not diagnose infection. The derivation work used measurements around the suspected-infection time and tested different windows. The page’s explicit same-assessment confirmation is a conservative site data-pairing rule to avoid creating a score from observations that were never documented together; it is not a claim that the original study required the same minute, not the original requirement for identical-minute measurement. [1, 2]

What this calculator actually does

1. Confirms an adult known or suspected infection context.
2. Confirms the conservative same-assessment pairing used by this page.
3. Reads respiratory rate, systolic blood pressure, and an external mentation assessment.
4. Applies the three fixed criteria and, only when all are assessable, reports 0–3 and the original ≥2 state.
5. 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.

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]

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]

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 frozen 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 must belong to the confirmed assessment; the site’s conservative pairing rule must not stitch different assessments together, and it is not the original same-minute requirement.

Examples show frozen 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]