qSOFA of 2 or 3 – what does it mean?
⚠︎ Learning page – classification and study figures only, no treatment recommendation.
In short
A qSOFA of 2 or 3 is positive according to Sepsis-3: in suspected infection outside the ICU it indicates an increased risk of poor outcome. It is a warning sign, not a definition of sepsis.
In the validation cohort of Seymour et al. (2016), in-hospital mortality with 2 or more points was 3 to 14 times higher than with fewer than 2 points across all deciles of baseline risk. The 24% of encounters with 2 or 3 points accounted for 70% of deaths.
The figures describe groups in the cited studies, not the risk of an individual person. This page contains no treatment or management recommendation.
How 2–3 points come about
Each of the three criteria scores 1 point:
- 2 points: respiratory rate ≥ 22/min + altered mentation (GCS < 15); respiratory rate ≥ 22/min + systolic BP ≤ 100 mmHg; altered mentation (GCS < 15) + systolic BP ≤ 100 mmHg
- 3 points: respiratory rate ≥ 22/min + altered mentation (GCS < 15) + systolic BP ≤ 100 mmHg
What the derivation study describes
Seymour et al. (2016) derived qSOFA from 148,907 encounters with suspected infection in 12 hospitals and tested it in four further data sets. The derivation used GCS ≤ 13; a simpler definition (any altered mentation, GCS < 15) did not perform significantly differently.
Outside the ICU, qSOFA predicted in-hospital mortality with an AUROC of 0.81. Across the range of 0 to 3 points, mortality ranged from 1% to 24%. Most encounters with infection (73–90%) had fewer than 2 points.
Not a sole screening tool
The 2021 Surviving Sepsis Campaign recommends against using qSOFA compared with SIRS, NEWS or MEWS as a single screening tool for sepsis or septic shock, because its sensitivity is low.
Both ranges at a glance
| qSOFA | Interpretation (Sepsis-3) |
|---|---|
| 0–1 | negative |
| 2–3 | positive |
Calculate it yourself
Enter the criteria in the qSOFA score calculator – it runs only in your browser.
FAQ
What does a qSOFA of 2 mean?▾
Two of the three criteria are met, so qSOFA is positive. According to Seymour et al. (2016), in-hospital mortality with 2 or more points was 3 to 14 times higher than with fewer than 2 points.
Is a positive qSOFA sepsis?▾
No. According to Sepsis-3, sepsis is life-threatening organ dysfunction, operationalised as an acute increase in SOFA score of at least 2 points. qSOFA is a quick test without laboratory values.
References
- Singer M et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801–10. · PubMed
- Seymour CW et al. Assessment of clinical criteria for sepsis (Sepsis-3). JAMA 2016;315:762–74. · PubMed · full text (PMC)
- Evans L et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med 2021;49:e1063–e1143. · PubMed
Learning page for medical education only: classification and figures reported in the cited sources, no treatment or management recommendation, not for use in patients; not a medical device. Last updated: 10/2026 · Dr. Pascal Bafteh