Update in the Treatment of Sepsis and Septic Shock: Transitioning from SIRS to SOFA

Abstract

There are several outcome prediction models that are currently available for use in clinical practice. The widely used SIRS was introduced to a larger audience in 1991 at the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference with the goal of aiding in the early detection of sepsis. The use of the SIRS criteria is highly sensitive, as >90% of patients admitted to the ICU meet the SIRS criteria. The use of SIRS has been especially beneficial in the early diagnosis of sepsis.

The Sequential Organ Failure Assessment (SOFA) score is an objective score that allows for calculation of both the number and the severity of organ dysfunction. It has been promoted as a more specific marker of sepsis and has been validated by large retrospective studies. The qSOFA, quick sequential organ assessment, score is easier to calculate bedside assessment that may identify patients with suspected infection who are at greater risk for a poor outcome outside the intensive care unit (ICU). The following chapter explains the SOFA and qSOFA score to identify sepsis and the current recommendations and supporting evidence in the treatment of sepsis.