feature:

Full SOFA Score: Data Layer + Scoring Engine

Glasgow Coma Scale: Data Layer + Scoring Engine

VigilCareClinicalAPI/Sepsis/QsofaCalculator.cs

@@ -10,19 +10,18 @@ public static class QsofaCalculator
     public static readonly IReadOnlySet<string> QsofaCodeSet =
         new HashSet<string>(QsofaCodes);
 
-    // qSOFA criteria (Sepsis-3 consensus):
-    // - Respiratory rate ≥ 22 breaths/min
-    // - Systolic blood pressure ≤ 100 mmHg
-    // - Altered mentation: AVPU score ≥ 1 (any non-Alert state)
     public static bool MeetsCriterion(string observationCode, decimal value) =>
         observationCode switch
         {
             "RESP_RATE"   => value >= 22m,
             "SYSTOLIC_BP" => value <= 100m,
             "AVPU"        => value >= 1m,
-            _              => false
+            _             => false
         };
 
+    public static bool MeetsGcsAlteredMentation(int gcsTotal) =>
+        GcsCalculator.MeetsQsofaAlteredMentation(gcsTotal);
+
     public static string CriterionKey(Guid encounterId, string code) =>
         $"qsofa:{encounterId}:{code}";
 

VigilCareClinicalAPI/Sepsis/QsofaDetector.cs

@@ -68,6 +68,44 @@ public class QsofaDetector
         return created ? QsofaResult.AlertCreated : QsofaResult.AlertAlreadyOpen;
     }
 
+    public async Task<QsofaResult> SyncAlteredMentationAsync(
+        Guid encounterId,
+        Guid patientId,
+        CancellationToken ct = default)
+    {
+        var cache = _redis.GetDatabase();
+        var avpuKey = QsofaCalculator.CriterionKey(encounterId, "AVPU");
+        var gcsValues = await cache.StringGetAsync(GcsCalculator.AllComponentKeys(encounterId));
+
+        if (gcsValues.All(v => v.HasValue))
+        {
+            var eye = decimal.Parse(gcsValues[0]!);
+            var verbal = decimal.Parse(gcsValues[1]!);
+            var motor = decimal.Parse(gcsValues[2]!);
+            var total = GcsCalculator.ComputeTotal(eye, verbal, motor)!.Value;
+
+            if (QsofaCalculator.MeetsGcsAlteredMentation(total))
+            {
+                await cache.StringSetAsync(
+                    avpuKey, "1", TimeSpan.FromSeconds(QsofaTtlSeconds));
+            }
+            else
+            {
+                await cache.KeyDeleteAsync(avpuKey);
+            }
+        }
+
+        var allKeys = QsofaCalculator.AllCriterionKeys(encounterId);
+        var values = await cache.StringGetAsync(allKeys);
+        var activeCount = QsofaCalculator.CountActiveCriteria(values);
+
+        if (activeCount < 2)
+            return QsofaResult.InsufficientCriteria(activeCount);
+
+        var created = await TryCreateAlertAsync(encounterId, patientId, activeCount, values, ct);
+        return created ? QsofaResult.AlertCreated : QsofaResult.AlertAlreadyOpen;
+    }
+
     private async Task<bool> TryCreateAlertAsync(
         Guid encounterId,
         Guid patientId,