Using sepsis scores in emergency department and ward patients

Sepsis-3, published in 2016, defined sepsis as 'life-threatening organ dysfunction caused by a dysregulated host response to infection'. Instead of systemic inflammatory response syndrome (SIRS), calculating the Sequential Organ Failure Assessment (SOFA) score was recommended. The complexity of SOFA also led to the introduction of quick SOFA (qSOFA) as a bedside tool. The simultaneous removal of SIRS and introduction of qSOFA belies their significant differences, with SIRS having a high sensitivity but very low specificity, and qSOFA being very specific for a poor outcome, but having a lower sensitivity than SIRS. In the UK, the variables within qSOFA are collected on a regular and repeated basis, along with additional variables, as part of the National Early Warning Score (NEWS). A knowledge of SIRS, qSOFA and NEWS is of value in assessing patients with suspected sepsis, as discussed in this article.