A 1991 consensus conference defined sepsis as a host?s systemic inflammatory response syndrome (SIRS) to infection. The Third International Consensus Definitions for Sepsis and Septic Shock in 2016 defined Sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Clinical criteria to identify patients with Sepsis are suspected or documented infection and an acute increase of ≥2 SOFA points (a proxy for organ dysfunction). Screening for patients likely to have Sepsis is using clinical scoring system termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100mmHg or less. Septic shock is a subset of Sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Clinical criteria to identify septic shock are Sepsis with a necessary vasopressor therapy to elevate MAP ≥65 mm Hg and lactate >2 mmol/L (18 mg/dL) despite adequate fluid resuscitation.

As a hospital administrator and Sepsis epidemiology researcher, I agree with the new definition. The new definition offered a simple method for medical practitioners outside ICU to recruit potential sepsis patients for early aggressive intervention. The consensus for this definition was developed using death or over 3 days ICU stay as an end point and was validated in several Sepsis database. For clinical trial and epidemiology studies, the new Sepsis definition has a better predictive validity for death than SIRS and avoids the confusion of Sepsis and Severe Sepsis.