The Use of qSOFA in the Emergency Department

The concept of sepsis has recently been redefined by an International Task Force. The task force recommended the use of the qSOFA score instead of SIRS criteria to identify patients at high risk of mortality from sepsis outside of the ICU, including in Emergency Departments. However, there are concerns from ED clinicians using qSOFA in ED septic patients in that it may not reflect the ED population at large. The primary outcome for qSOFA is mortality which is not the only outcome measure considered in the ED. From the ED perspective, the priorities are to identify the septic patient and then initiating timesensitive interventions.

A systematic review was performed using The AAEM CPC Statements on Protocols for literature search/grading process to identify articles that could answer the following questions: (1) How does qSOFA perform as a diagnostic tool for ED patients who may have sepsis or septic shock?, (2) How does qSOFA perform as a prognostic indicator in ED patients diagnosed with sepsis or septic shock?

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Reference and Literature Grading  (PDF)