Is qSOFA an adequate replacement for SIRS as an assessment of sepsis?

Sepsis is a life-threatening organ dysfunction induced by a dysregulated host response to

infection. This new Sepsis-3 definition relies on the SOFA score, which predicts mortality
based on organ dysfunction and offers better stratification of mortality risk. QSOFA was
developed to allow for more rapid identification of sepsis. By using only 3 of the SOFA
criteria, qSOFA circumvents the lengthy laboratory tests and offers a prompt bedside
prediction of mortality. In comparison, the SIRS criteria places excessive emphasis on
inflammation, overestimating the number of patients diagnosed with sepsis.

The aim of this study was to assess the ability of qSOFA to adequately replace SIRS as an
assessment for sepsis. We have searched the literature for studies comparing the efficacies of
SIRS and qSOFA.

QSOFA has a higher predictive validity of in-hospital mortality than SIRS. The higher
specificity of qSOFA makes it very effective at recognizing patients at risk of adverse
outcomes. This may benefit the patients from urgent senior medical attention and reduce rates
of inappropriate antibiotic use. Nevertheless, its low sensitivity carries a high risk of missing
patients with sepsis when used alone. QSOFA is therefore not a replacement for SIRS, but
could be used as an adjunct instead.

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References
1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al.
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-
3). Jama-Journal of the American Medical Association. 2016;315(8):801-10.
2. N Gunn, C Haigh and JR Thomson TRIAGE OF SEPSIS PATIENTS: SIRS OR
QSOFA WHICH IS BEST?. Emerg Med J 2016 33: 909-910.
3. Jean-Louis Vincent1*, Greg S. Martin2 and Mitchell M. Levy, Vincent et al. qSOFA
does not replace SIRS in the definition of sepsis Critical Care (2016) 20:210.