Detecting Sepsis in an Emergency Department: SIRS vs. qSOFA.

Sepsis is a condition that can progress to serious illness and even death. The diagnosis of sepsis is difficult because no unique biomarker exists. With this, health care providers must rely on clinical diagnostic criteria to guide diagnosis. Systemic Inflammatory Response Syndrome (SIRS) criteria have been used for diagnosis since 1992. The more recent attempt to replace SIRS with the quick Sequential Organ Failure Assessment (qSOFA) for assessment of potentially septic patients is troublesome. The qSOFA was designed as a prognostic and not diagnostic tool. Using established processes of evidence-based medicine, it is shown herein that qSOFA fails to meet the definition of a diagnostic assessment tool. Thus, the SIRS assessment should remain the gold standard tool for detecting patients at risk of "sepsis."