Sepsis Diagnosis and Management

Definition and Criteria

The Society of Critical Care Medicine recommends using the quick Sequential Organ Failure Assessment (qSOFA) score, which includes a systolic blood pressure (SBP) criterion of ≤100 mmHg, to identify patients with suspected infection who are at higher risk of adverse outcomes 1, 3
The qSOFA score has a higher sensitivity for identifying patients at risk, allowing for earlier interventions, and includes three simple criteria: SBP ≤100 mmHg, respiratory rate ≥22/min, and altered mental status 1, 3
A qSOFA score ≥2 indicates a higher risk of mortality and need for intensive care 3, 2

The traditional definition of hypotension uses a SBP threshold of <90 mmHg, which is used in various guidelines to define septic shock and initiate vasopressor therapy 7, 5
The American College of Critical Care Medicine recommends using the qSOFA score as a screening tool, but notes that it should not be used as a definitive diagnostic criterion 2, 4

The use of a SBP threshold of ≤100 mmHg allows for earlier identification of patients at risk and facilitates early intervention, which is crucial for improving outcomes in sepsis 2, 9
The qSOFA score has a better negative predictive value for adverse outcomes, but may generate overdiagnosis in some patients 2, 3