Consensus Definitions for Sepsis and Septic Shock

A critical care task force has proposed a new definition for sepsis and septic shock based on advances in science and the testing of clinical criteria against patient outcomes in EHR data.

The Task Force now recommends that sepsis and septic shock be defined as follows:

  • Definitions:
    • Sepsis: Life-threatening organ dysfunction caused by a dysregulated host response to infection
    • Septic shock: Sepsis with circulatory and cellular/metabolic abnormalities profound enough to substantially increase mortality
  • Clinical Criteria:
    • Sepsis: Suspected or documented infection and an acute increase of ≥ 2 SOFA points (a proxy for organ dysfunction)
    • Septic Shock: Sepsis and vasopressor therapy needed to elevate MAP ≥ 65 mmg Hg and lactate > 2 mmol/L (18 mg/dL) after adequate fluid resuscitation

In an accompanying editorial, Edward Abraham reviews what the new definitions accomplish and leave unaccomplished for our understanding of sepsis.

To learn more, browse the entire JAMA Network Sepsis and Critical Care collections.

Related Multimedia

JAMA Whiteboard: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

The JAMA Report: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

JAMA Author Interview: Dr. Derek Angus on The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

ESICM Interview with Dr Mervyn Singer, lead author of The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

ESICM Interview with Dr Shankar-Hari, lead author of Developing a New Definition and Assessing New Clinical Criteria for Septic Shock (Part 1)

ESICM Interview with Dr Shankar-Hari, lead author of Developing a New Definition and Assessing New Clinical Criteria for Septic Shock (Part 2)

Important Sepsis Articles From The JAMA Network

Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014

Chanu Rhee and Coauthors

JAMA | Original Investigation, September 13, 2017

Counting Sepsis, an Imprecise but Improving Science

Kristina E. Rudd and Coauthors

JAMA | Editorial, September 13, 2017

Epidemiology of Sepsis Among Adolescents at Community Hospital Emergency Departments: Implications for Rory’s Regulations

Idris V. R. Evans and Coauthors

JAMA Pediatrics | Research Letter, August 14, 2017

In Treating Sepsis, Questions About Timing and Mandates

Jennifer Abbasi

JAMA | Medical News & Perspectives, August 8, 2017

Association Between US Norepinephrine Shortage and Mortality Among Patients With Septic Shock

Emily Vail and Coauthors

JAMA | Original Investigation, April 11, 2017

A Quantitative, Risk-Based Approach to the Management of Neonatal Early-Onset Sepsis

Michael W. Kuzniewicz and Coauthors

JAMA Pediatrics | Original Investigation, April 2017

Association Between Early Lactate Levels and 30-Day Mortality in Clinically Suspected Sepsis in Children

Halden F. Scott and Coauthors

JAMA Pediatrics | Original Investigation, March 2017

Management of Sepsis and Septic Shock

Michael D. Howell and Andrew M. Davis

JAMA | JAMA Clinical Guidelines Synopsis, February 28, 2017

Surviving Sepsis Guidelines: A Continuous Move Toward Better Care of Patients With Sepsis

Daniel De Backer and Todd Dorman

JAMA | Viewpoint, February 28, 2017

Proportion and Cost of Unplanned 30-Day Readmissions After Sepsis Compared With Other Medical Conditions

Florian B. Mayr and Coauthors

JAMA | Research Letter, February 7, 2017

Association Between Early Lactate Levels and 30-Day Mortality in Clinically Suspected Sepsis in Children

Halden F. Scott and Coauthors

JAMA Pediatrics | Original Investigation, January 9, 2017

Act Fast and Think Sepsis

JAMA | News From the Centers for Disease Control and Prevention, October 11, 2016

Evaluating Glucocorticoids for Sepsis: Time to Change Course

Sachin Yende and B. Taylor Thompson

JAMA | Editorial, October 3, 2016

Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?

Peter Bentzer and Coauthors

JAMA | The Rational Clinical Examination, September 27, 2016

The Challenging Task of Improving the Recovery of ICU Survivors

Shannon L. Goddard and Neill K. J. Adhikari

JAMA | Editorial, June 28, 2016

Immunosuppression and Secondary Infection in Sepsis: Part, Not All, of the Story

Derek C. Angus and Steven Opal

JAMA | Editorial, March 15, 2016

Sepsis and the Global Burden of Disease in Children

Niranjan Kissoon and Timothy M. Uyeki

JAMA Pediatriacs | Viewpoint, February 2016

Assessment of a Central Line–Associated Bloodstream Infection Prevention Program in a Burn-Trauma Intensive Care Unit

Lois Remington and Coauthors

JAMA Surgery | Research Letter, December 23, 2015

Association of Intensive Care Unit Admission With Mortality Among Older Patients With Pneumonia

Thomas S. Valley and Coauthors

JAMA | Original Investigation, September 22/29, 2015

Septic Shock: Advances in Diagnosis and Treatment

Christopher W. Seymour and Matthew R. Rosengart

JAMA | Review, August 18, 2015

Readmission Diagnoses After Hospitalization for Severe Sepsis and Other Acute Medical Conditions

Hallie C. Prescott and Coauthors

JAMA | Research Letter, March 10, 2015

Lactate in Sepsis

Hernando Gomez and John A. Kellum

JAMA | JAMA Diagnostic Test Interpretation, January 13, 2015

Sepsis Mandates: Improving Inpatient Care While Advancing Quality Improvement

Colin R. Cooke and Theodore J. Iwashyna

JAMA | Viewpoint, October 8, 2014

Hospital Deaths in Patients With Sepsis From 2 Independent Cohorts

Vincent Liu and Coauthors

JAMA | Research Letter, July 2, 2014

Mortality Related to Severe Sepsis and Septic Shock Among Critically Ill Patients in Australia and New Zealand, 2000-2012

Kirsi-Maija Kaukonen and Coauthors

JAMA | Original Investigation, April 2, 2014

Declining Case Fatality Rates for Severe Sepsis: Good Data Bring Good News With Ambiguous Implications

Theodore J. Iwashyna and Derek C. Angus

JAMA | Editorial, April 2, 2014

Guideline Promotes Early, Aggressive Sepsis Treatment to Boost Survival

Bridget M. Kuehn

JAMA | Medical News and Perspectives, March 13, 2013

Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients

Flavio Lopes Ferreira and Coauthors

JAMA | Caring for the Critically Ill Patient, October 10, 2001

Read more about sepsis from The JAMA Network