Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
John M LitellMichael A Puskarich

Abstract

Effective sepsis resuscitation depends on useful criteria for prompt identification of eligible patients. These criteria should reliably predict a discharge diagnosis of sepsis, ensuring that interventions are triggered for those who need it while avoiding potentially harmful interventions in those who do not. We sought to determine the proportion of patients meeting sepsis criteria in the emergency department (ED) that was ultimately diagnosed with sepsis and to quantify the subset of nonseptic patients with risk factors for harm from fluid resuscitation. This retrospective cohort study of adult ED patients at a tertiary academic medical center included vital signs and laboratory results from the first 6 hours, plus administration of intravenous antibiotics, to determine if patients met 2016 Sepsis-3 consensus criteria. If these patients also had hypotension and lactic acidosis, we categorized them as Sepsis-3 plus shock. We used discharge ICD-9 codes to determine if patients were ultimately diagnosed with sepsis. Over 8 years, 3,121 ED patients met 2016 Sepsis-3 criteria in the first 6 hours. Of these, only 25% and 48% met explicit and implicit criteria for a discharge diagnosis of sepsis. Of 1,032 patients with Sepsis-3 plus...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Apr 12, 2003·Critical Care Medicine·Mitchell M LevyUNKNOWN SCCM/ESICM/ACCP/ATS/SIS
Apr 18, 2003·The New England Journal of Medicine·Greg S MartinMarc Moss
Jun 19, 2007·Chest·Todd W RiceUNKNOWN National Institutes of Health, National Heart, Lung, and Blood Institute ARDS Network
Dec 15, 2010·Disaster Medicine and Public Health Preparedness·Colin K GrissomJames F Orme
Feb 28, 2013·Critical Care Medicine·David F GaieskiBrendan G Carr
Mar 12, 2013·Lancet·Jean-Louis VincentKevin J Tracey
Nov 10, 2013·Critical Care Medicine·Michael R FilbinDaniel J Pallin
Sep 25, 2014·Critical Care Medicine·Daniel Pilsgaard HenriksenAnnmarie Touborg Lassen
Sep 29, 2015·American Journal of Respiratory and Critical Care Medicine·Carolin FleischmannUNKNOWN International Forum of Acute Care Trialists
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Sep 18, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Matthew B RivaraRajnish Mehrotra
May 23, 2017·The New England Journal of Medicine·Christopher W SeymourMitchell M Levy
May 14, 2018·Annals of Emergency Medicine·Wesley H SelfUNKNOWN CLOVERS Protocol Committee and NHLBI Prevention and Early Treatment of Acute Lung Injury (PETAL) Network Investigators
Jul 26, 2018·JAMA : the Journal of the American Medical Association·Idris V R EvansChristopher W Seymour
May 20, 2019·JAMA : the Journal of the American Medical Association·Christopher W SeymourDerek C Angus

❮ Previous
Next ❯

Citations

Aug 5, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher M Fung, William J Meurer
Feb 26, 2022·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Justin Ang, Adrian Boyle

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.