News: Most qSOFA-positive patients don’t have sepsis, study finds

The quick sequential organ failure assessment (qSOFA) is often used as a predictive assessment to determine if a patient has sepsis, allowing the hospital to start the various sepsis care measures faster and potentially save more lives. A new study published in Chest, however, found that most patients who are qSOFA-positive on admission do not have sepsis.

The researchers studied patients who met at least two of the following qSOFA criteria within one day of admission to 85 hospitals from 2012 to 2015:

• Respiratory rate greater than or equal to 22/minute
• Altered mentation
• Systolic blood pressure less than or equal to 100 mmHg

They then assessed the patients’ records for suspected infection (using cultures and antibiotic use) and sepsis based on Sepsis-3 criteria.

Of the 271,500 patients who had a positive qSOFA score on admission (27% of the entire admitted population), one in three had a suspected infection and only one in six had sepsis. This means that qSOFA’s positive predictive value for infection is 31.3% and 17.4% for sepsis, the researchers wrote.

This means that, if a facility is using Sepsis-3 criteria specifically, the qSOFA assessment has a low sensitivity for identifying suspected infection and sepsis, according to the study. In response to these findings, more sensitive sepsis screening tools are needed, according to the researchers.

Editor’s note: To read the full study findings, click here. To read more about sepsis screening and criteria, click here. To read an article related to another study that found that the systemic inflammatory response syndrome (SIRS) critera were more sensitive than qSOFA for sepsis screening, click here.