qSOFA Score Calculator for Suspected Infection

Three-signal infection risk beacon

qSOFA Score Calculator

Count the three original Sepsis-3 quick SOFA criteria in an adult with suspected infection outside the ICU: respiratory rate, systolic blood pressure, and altered mentation. Each signal stays visible so the number cannot hide the bedside problem.

Sepsis and septic shock are medical emergencies. New confusion, severe breathing difficulty, clammy or mottled skin, very low blood pressure, inability to wake, or rapid deterioration requires emergency care. In the United States call 911; Do not delay emergency care to use this calculator.

Set the bedside signals

qSOFA bedside result

Positive criteria3 of 3qSOFA 3—urgent escalation and full assessment
Respiratory rate1 point24/min meets ≥22
Systolic pressure1 point98 mm Hg meets ≤100
Mentation1 pointAltered from baseline
Action meaning

A qSOFA of 3 identifies an adult with suspected infection who may be at increased risk of a poor outcome. Escalate promptly, evaluate for organ dysfunction, and follow the sepsis pathway. qSOFA neither diagnoses sepsis nor selects antibiotics, fluids, vasopressors, imaging, or disposition.

What quick SOFA was built to identify

The Third International Consensus Definitions for Sepsis and Septic Shock introduced quick SOFA, or qSOFA, as a rapid bedside prompt for adults with suspected infection in out-of-hospital, emergency department, or general hospital ward settings. Patients with at least two of three findings were more likely to have poor outcomes typical of sepsis.

The three variables need no laboratory test: respiratory rate at least 22 per minute, systolic blood pressure at most 100 mm Hg, and altered mentation. Each present finding scores one point, for a total from zero to three. The original consensus did not make qSOFA a definition of sepsis; organ dysfunction and the clinical syndrome remain central.

This calculator uses the exact inclusive thresholds. A respiratory rate of 22 scores one, a systolic pressure of exactly 100 scores one, and any clinically relevant alteration in mentation scores one. Values on the other side—21 breaths/min and 101 mm Hg—score zero, even though the patient can still be dangerously ill.

The three-point count

qSOFA = 1 if RR ≥22 + 1 if SBP ≤100 + 1 if mentation is altered

The demonstration uses 24 breaths per minute, systolic pressure 98 mm Hg, and altered mentation. All three thresholds are met, so the total is 3. The interface colors each beacon red and does not translate the score into a mortality percentage.

Changing respiratory rate to 21 removes that point. Changing systolic pressure to 101 removes the pressure point. Selecting baseline mentation removes the third point. A total below two reduces the qSOFA signal but cannot be called “sepsis negative.” The score’s limited sensitivity is one reason contemporary guidance discourages qSOFA as the only screening method.

Do not average repeated vital signs to make a score disappear. Use the observation and timeframe required by local protocol, document treatment already given, and respond to deterioration. A patient whose blood pressure rose after resuscitation still has a clinically meaningful earlier hypotensive episode.

Current SCCM guidance: do not screen with qSOFA alone

Surviving Sepsis Campaign guidance recommends NEWS/NEWS2, MEWS, or SIRS over qSOFA as a single in-hospital sepsis screening method. Sepsis cannot be ruled in or ruled out by one score, biomarker, or test.

qSOFA is compact and relatively specific for a higher-risk phenotype, but it can miss early sepsis. A younger adult may maintain blood pressure and mentation while infection and organ dysfunction are evolving. Immunosuppression, pregnancy, medication, neuropathy, or atypical presentation can change the pattern.

A high score should accelerate evaluation, not replace it. A low score should not reassure the team when there is fever or hypothermia, tachycardia, hypoxemia, oliguria, rising lactate, thrombocytopenia, kidney or liver injury, mottling, rigors, rapidly changing function, or strong clinical concern.

Hospitals should use their validated screening and response workflow. This calculator labels qSOFA as a bedside risk beacon, not “the sepsis calculator.”

From bedside concern to emergency treatment

Recognize
Suspected infection and acute deterioration
Escalate
Activate clinician or rapid-response assessment
Evaluate
Perfusion, organ dysfunction, source, labs, imaging, cultures
Treat
Begin time-critical care under current protocol

Sepsis is a dysregulated response to infection that causes life-threatening organ dysfunction. The clinical team evaluates the suspected source, airway and breathing, circulation, mental status, skin perfusion, urine output, lactate when indicated, blood counts, metabolic and organ-function tests, cultures, and imaging. Treatment and resuscitation should begin immediately when sepsis or septic shock is recognized.

Antimicrobial timing depends on shock and infection likelihood under current guidance. Obtain cultures when doing so does not cause a substantial delay, choose therapy based on likely source and resistance patterns, and reassess for alternative diagnoses. Fluid and vasopressor decisions require patient-specific hemodynamic assessment; qSOFA has no dosing information.

Measure each signal carefully

SignalBetter observation practicePotential confounders
Respiratory rateCount respirations directly for an adequate interval while observing pattern and effort.Pain, anxiety, fever, acidosis, medication, exertion, ventilation support, or inaccurate chart defaults.
Systolic pressureUse an appropriate cuff, repeat an unexpected value, and assess perfusion rather than relying on one number.Wrong cuff size, arrhythmia, movement, vasopressors, chronic low pressure, or device error.
MentationCompare with documented baseline and assess orientation, attention, arousal, and behavior in context.Dementia, stroke, seizure, sedatives, intoxication, hypoglycemia, language barrier, sleep, or psychiatric illness.

Altered mentation in qSOFA is often operationalized as a Glasgow Coma Scale below 15, but local implementation may use another clear definition. The key is an acute clinically important change, not a casual label. Check bedside glucose promptly because hypoglycemia is both dangerous and treatable.

qSOFA is not full SOFA

qSOFA has three bedside findings and a 0–3 range. The Sequential Organ Failure Assessment examines six organ systems and requires laboratory values and organ-support information. Their names are related, but qSOFA is not a shortened arithmetic version of the full score and the totals cannot be converted.

Sepsis-3 operationalized organ dysfunction as an acute increase of at least two points in the SOFA framework in the setting of infection. In 2025, SOFA-2 updated the full ICU organ dysfunction score to contemporary thresholds and support modalities. That update does not turn qSOFA into a diagnosis or change the original three qSOFA cutoffs displayed here.

Use the version specified by the clinical protocol, study, quality measure, or EHR. Never mix a qSOFA result with SOFA-1 or SOFA-2 component points.

Population and privacy boundaries

The original qSOFA context is adult suspected infection outside the ICU. Pediatric sepsis uses age-specific physiology and pediatric protocols. ICU patients already have detailed monitoring and organ-support information; full assessment is more appropriate. Pregnancy changes normal vital signs and requires obstetric-aware escalation.

Home users should not calculate qSOFA to decide whether to seek care. A normal home blood pressure or counted breathing rate cannot exclude sepsis. Call emergency services for severe symptoms; contact a clinician promptly for possible infection with worsening condition.

Do not enter names, dates of birth, or medical record identifiers. This calculator needs only three findings and does not store or create an authorized clinical record. Copy verified results into the appropriate system according to privacy and documentation policy.

Document the observation and the response

A useful handoff records the exact respiratory rate, systolic pressure, mental-status finding, observation time, suspected source, baseline, oxygen and support in use, recent medications, fluids already given, urine output, and direction of change. “qSOFA 2” alone omits which two signals were present and what the team did.

Escalation should be closed-loop. Name the clinician or response team contacted, communicate the concern directly, repeat vital signs at the required interval, and confirm that ordered tests and treatments are underway. If the patient worsens while waiting, escalate again rather than assuming the original page or alert is sufficient.

For quality review or research, define the measurement window and missing-data method before calculating. Do not treat an undocumented value as normal merely to complete a score. Clinical care should address missing critical information by measuring it promptly; retrospective analysis should follow its prespecified data rules.

Frequently asked questions

Does qSOFA 2 diagnose sepsis?

No. It flags greater risk in an adult with suspected infection and should prompt assessment. Sepsis remains a clinical diagnosis involving infection and organ dysfunction.

Does qSOFA 0 rule out sepsis?

No. qSOFA can be low early in illness and is not recommended as the only screening method.

Is a blood pressure of 100 positive?

Yes. The criterion is systolic pressure less than or equal to 100 mm Hg, so exactly 100 scores one point.

Is a respiratory rate of 22 positive?

Yes. The respiratory criterion is at least 22 breaths per minute.

Can qSOFA be used in children?

No. Children require age-specific pediatric sepsis recognition and treatment pathways.

Why does the calculator not estimate mortality?

A browser percentage would ignore population, cause, timing, treatment, comorbidities, and trajectory. qSOFA supports escalation, not individualized prognosis.

Related U.S. planning context

It does not determine medical bills, insurance coverage, disability, or emergency treatment.

References

Professional education only. qSOFA cannot diagnose or exclude sepsis and must not delay emergency assessment or treatment.

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