Sepsis Awareness

 Month

1. Background

  • SIRS (Systemic Inflammatory Response Syndrome) was originally part of the 1991 and 2001 sepsis definitions. It focused on detecting a generalized inflammatory state (e.g., fever, tachycardia, tachypnea, leukocytosis/leukopenia).
  • SOFA (Sequential Organ Failure Assessment) became central after the Sepsis-3 definition (2016), which redefined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection.

2. Role of SIRS Today

  • Pros:
  • Sensitive and easy to apply at the bedside.
  • Helps in early recognition of possible infection/inflammation.
  • Still used in many ED triage systems and teaching because of simplicity.
  • Cons:
  • Poor specificity (many non-infectious conditions meet SIRS criteria).
  • Not always predictive of severity or mortality.
  • Current role:
    Mainly used for         screening and initial triage, not for defining sepsis severity.

3. Role of SOFA Today

  • Pros:
  • Organ dysfunction–based (respiratory, cardiovascular, hepatic, coagulation, renal, neurologic).
  • Strongly correlates with morbidity and mortality risk.
  • Central to Sepsis-3 definition (sepsis = infection + SOFA score ≥2).
  • Cons:
  • Requires labs (PaO₂/FiO₂, bilirubin, platelets, creatinine) → not always immediately available.
  • Current role:
    The         standard tool for defining and stratifying sepsis severity in ICU and research. A SOFA increase ≥2 points identifies sepsis; persistent high SOFA correlates with mortality.

4. qSOFA vs. SIRS

  • qSOFA (altered mentation, SBP ≤100, RR ≥22) was introduced for bedside rapid assessment outside the ICU.
  • It performs better than SIRS for mortality prediction but is less sensitive for sepsis screening.
  • Current practice: qSOFA is an early warning tool, not a replacement for SOFA or SIRS.

5. Practical Integration Today

  • Emergency Department / triage: SIRS or qSOFA for quick flagging.
  • ICU / inpatient setting: SOFA for diagnosis, prognosis, and monitoring.
  • Research & guidelines: Sepsis-3 definition relies on SOFA, not SIRS.

✅ Summary:

  • SIRS is now seen as a broad early warning system—useful for identifying patients who may be septic but too nonspecific to define sepsis severity.
  • SOFA is the gold standard for sepsis definition and prognosis under Sepsis-3, as it captures organ dysfunction and correlates with outcomes.
  • Together, they serve complementary roles: SIRS/qSOFA for screening, SOFA for defining and stratifying sepsis.