qSOFA Score Calculator (Quick Sequential Organ Failure Assessment)

Background.

qSOFA is a three-item bedside prompt introduced with the Sepsis-3 consensus definitions in 2016: a respiratory rate of 22 or more, a systolic blood pressure of 100 or less, and altered mentation defined as a Glasgow Coma Scale below 15. Two or more of the three identifies a patient with suspected infection who is at greater risk of a prolonged intensive care stay or of dying in hospital. It is a clinical aid for clinicians and it is not a diagnosis.

The most important thing this page can tell you is how the score should not be used. The 2021 Surviving Sepsis Campaign guideline issues a strong recommendation, on moderate-quality evidence, against using qSOFA compared with SIRS, NEWS or MEWS as a single screening tool for sepsis or septic shock. The stated reason is poor sensitivity: in the derivation work only about 24 percent of infected patients had a qSOFA of 2 or 3, even though those patients accounted for about 70 percent of poor outcomes. In other words a positive qSOFA is a genuine alarm, but the absence of one tells you very little — and using it as your screen means most of your septic patients never trigger it. That caveat sits beside the result on this page, not in an accordion.

So what is it for? A positive qSOFA should raise the possibility of sepsis and prompt a fuller assessment, escalation and, where appropriate, a full SOFA score. It is fast, requires no blood tests, and can be computed from observations that are already being taken. Those are real virtues. They just do not add up to a screening instrument.

The two measured criteria have opposite inclusivity, which is worth reading twice. The respiratory rate criterion is met at 22 or more, so exactly 22 scores. The systolic pressure criterion is met at 100 or less, so exactly 100 scores. A patient breathing 21 times a minute with a systolic of 101 scores zero; a patient at 22 and 100 scores two and is qSOFA positive. One breath and one millimetre of mercury separate them, which is a lot of clinical weight to put on two observations that are themselves imprecise.

The mentation criterion has a definition, and reproductions often drop it. Sepsis-3 specifies a Glasgow Coma Scale below 15, not a general impression of confusion. A patient with long-standing dementia at their baseline does not automatically meet it; a patient who is newly disorientated does. If you have not assessed the GCS, you do not yet know whether the criterion is met.

qSOFA is also not a short version of SOFA, despite the name. SOFA grades six organ systems from 0 to 4 using arterial blood gases, platelet count, bilirubin, vasopressor requirement, GCS and creatinine, and runs from 0 to 24. qSOFA is three bedside observations with a maximum of 3. They answer related questions with completely different inputs, and a qSOFA of 2 tells you nothing about what a SOFA score would be.

One currency note. A Surviving Sepsis Campaign guideline dated 2026 has been published in Intensive Care Medicine. Its content could not be retrieved for this page, so nothing here should be taken as describing it — the recommendation quoted above is from the 2021 edition. If you are setting local policy, check the current guideline directly.

What is qsofa score calculator?

qSOFA — quick Sequential Organ Failure Assessment — is a three-criterion bedside tool introduced in the 2016 Sepsis-3 consensus definitions. Each criterion scores one point: respiratory rate of 22 breaths per minute or more, systolic blood pressure of 100 mmHg or less, and altered mentation with a Glasgow Coma Scale below 15. A total of 2 or more is considered positive.

It was developed from large electronic health record datasets as a way of identifying, outside the intensive care unit, which patients with suspected infection were likely to have a poor outcome. Its design constraint was that it should need no laboratory tests, so that it could be applied at the bedside, in a corridor, or in an ambulance.

Its standing has changed since it was introduced. The 2021 Surviving Sepsis Campaign guideline recommends against using it as a single screening tool for sepsis relative to SIRS, NEWS or MEWS, on the grounds of poor sensitivity. That does not make a positive qSOFA meaningless — it makes a negative one uninformative.

What it is not: a diagnosis of sepsis, a measure of organ dysfunction, an abbreviated SOFA total, or a substitute for a full assessment in a patient who looks unwell.

How to use this calculator.

1. 01Use it in a patient with suspected infection, outside the intensive care unit, as a prompt rather than as a screen.
2. 02Enter the respiratory rate counted over a full minute. The criterion is met at 22 or more — exactly 22 scores.
3. 03Enter the systolic blood pressure. The criterion is met at 100 or less — exactly 100 scores.
4. 04Answer the mentation item on a Glasgow Coma Scale below 15, not on a general impression of confusion. If the GCS has not been assessed, assess it first.
5. 05Treat a score of 2 or more as a reason to escalate, to reassess fully, and to consider a full SOFA score — not as a diagnosis.
6. 06Do not treat a score of 0 or 1 as reassurance. The score's sensitivity is poor and most patients who go on to do badly never reach 2.
7. 07Do not carry qSOFA thresholds into another score. CURB-65 uses a respiratory rate of 30 or more and a systolic below 90; those are different cut-offs for a different question.

The formula.

qSOFA adds one point for each of three criteria, giving a total from 0 to 3. Respiratory rate of 22 breaths per minute or more scores 1. Systolic blood pressure of 100 mmHg or less scores 1. Altered mentation, defined as a Glasgow Coma Scale below 15, scores 1. A total of 2 or more is qSOFA positive.

Rounding stage: there is none. Each criterion is worth exactly 1 and the total is an exact integer sum. Both measured values are compared against their thresholds exactly as entered, with no rounding before the comparison.

The inclusivity of the two measured thresholds runs in opposite directions, and reproducing one of them backwards changes the verdict for patients sitting exactly on the line. Respiratory rate is met at 22 or more, so 22 scores and 21 does not. Systolic pressure is met at 100 or less, so 100 scores and 101 does not. This calculator tests both at the value immediately below, at, and immediately above the threshold.

The positivity cut is a single step at 2. There is no partial credit and no intermediate band: 1 is negative, 2 is positive, and 3 is positive. Because each criterion is worth the same, a patient can become positive on any pair of the three.

Worked through the example on this page: a respiratory rate of 26 is 22 or more and scores 1; a systolic pressure of 96 is 100 or less and scores 1; a Glasgow Coma Scale of 13 is below 15 and scores 1. The total is 1 + 1 + 1 = 3, and 3 is 2 or more, so the verdict is qSOFA positive with all three criteria met.

The boundary case is worth constructing deliberately. A respiratory rate of exactly 22 with a systolic of exactly 100 and normal mentation gives a total of 2 — positive. Move to a rate of 21 and a systolic of 101, changing nothing else, and the total is 0. The score is a step function on two noisy measurements, which is one reason it should prompt assessment rather than replace it.

A worked example.

Frequently asked questions.

References& sources.

1. [1]Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810. Source of the three qSOFA criteria — respiratory rate ≥22/min, altered mentation (Glasgow Coma Scale below 15), systolic blood pressure ≤100 mmHg — and of the ≥2 threshold. (Consulted 2026-07-29.)
2. [2]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 (Sepsis-3). JAMA. 2016;315(8):762–774. The derivation and validation analysis behind qSOFA. (Bibliographic; consulted 2026-07-29.)
3. [3]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49(11):e1063–e1143. Source of the strong recommendation, on moderate-quality evidence, AGAINST using qSOFA compared with SIRS, NEWS or MEWS as a single screening tool, and of the sensitivity rationale (about 24% of infected patients had a qSOFA of 2 or 3, accounting for about 70% of poor outcomes). (Retrieved 2026-07-29.)
4. [4]Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Intensive Care Medicine, 2026. DOI 10.1007/s00134-026-08361-1. Listed because it exists and supersedes the 2021 edition for current practice. Its content could not be retrieved by automated fetch (the publisher redirects to an authenticated identity provider), and NO claim about what it says is made on this page. (Consulted 2026-07-29.)