Defining Criteria & Timeframes

#1 New infection Source (within 72o of surgery start time or 30 days postop)
2018 Sepsis Tool

1 calendar day between

Date Time suspected or confirmed source:
______ ______

SEPSIS (#1 & 2)

#1
#2 Presence of at least TWO of these signs/symptoms:
Date Time New Suspected or confirmed
□ ______ ______Temp > 38.3oC (101.0oF) or < 36oC (96.8oF) infection sources may include:

6 hours

SEVERE SEPSIS (#1, 2 & 3)

□ ______ ______HR > 90 acute appendicitis, acute cholecystitis,
□ ______ ______RR > 20 acute abdominal infection, acute
□ ______ ______WBC > 12 or < 4 diverticulitis, organ perforation/perforated
viscus, abscess, positive cultures,
anastomotic leak, gangrene/necrosis,

SEPTIC SHOCK (#1, 2, 3 & 4)

#3 Presence of at least ONE of these organ dysfunction/tissue hypoperfusion elements:
Date Time ‘suspected/ possible infection from xx’,

6 hours
□ ______ ______SBP < 90 physician diagnosis of infection or meets
□ ______ ______MAP < 65

SEPTIC SHOCK
MSQC definition of infection (SSI, UTI,
□ ______ ______SBP decrease > 40 from baseline PNA), empyema, meningitis, skin/soft
□ ______ ______Creatinine > 2.0 tissue infection, bone/joint infection,

12 hours
□ ______ ______Urine output < 0.5 mL/kg/hr for at least 2o wound infection, bloodstream catheter
□ ______ ______Bilirubin > 2 infection, endocarditis, implantable device
□ ______ ______Platelet count < 100 infection, acute sinus infection
□ ______ ______INR > 1.5 or PTT > 60

6 hours
□ ______ ______Lactate/Lactic Acid > 2

#4 Presence of at least ONE of the following: Lactate level > 4 mmol/L (a) or persistent #2
hypoperfusion/ hypotension elements (b or c)  Signs/symptoms must be new, not
Date Time related to a chronic condition
a. ______ ______Lactate/Lactic Acid > 4
b. Tissue hypoperfusion persists after fluid administration, evidenced by either: #3
□ ______ ______SBP < 90, or  Organ dysfunction criteria must be
□ ______ ______MAP < 65, or present at a site remote from the
□ ______ ______SBP decrease > 40 from last recorded SBP considered normal for patient infection source and cannot be
c. ______ ______Persistent hypotension requiring vasopressors for MAP ≥65 related to a chronic condition

When Preop Sepsis, Severe Sepsis or Septic Shock has been assigned, or when the postop infection source
is same as the preop source, or the same postop infection source was identified intraoperatively: Select the highest level:
 If you assigned Sepsis/Severe Sepsis/Septic Shock preop (or preop/intraop infection source was present but all Preoperative:
criteria were not met to assign it preop), do not assign the same or a lower level sepsis when the postop □ Sepsis
infection source is the same as the preop or intraop source unless it is at least POD7 □ Severe Sepsis
□ Septic Shock (highest)
 If you assigned Sepsis/Severe Sepsis preop: you can assign postoperative sepsis of a higher level than what was
assigned preop at any time when the postop infection source is the same as the preop or intraop source, if the Postoperative:
criteria are met □ Sepsis
□ Severe Sepsis
 If you assigned Sepsis/Severe Sepsis/Septic Shock preop: you can assign postoperative Sepsis/Severe □ Septic Shock (highest)
Sepsis/Septic Shock at any time with a different infection source postop, if the criteria are met