Sepsis recognition in the emergency department – impact on quality of care and outcome?

BACKGROUNG: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians. The study team independently rated quality of sepsis classification (American College of Chest Physicians/Society of Critical Care Medicine definitions), diagnostic workup, and guideline-adherent therapy in the ED. RESULTS: Of 487 included patients, 110 presented because of infection. Of those, 54 patients matched sepsis criteria, including 20 with organ damage and thus severe sepsis, as rated by the study team. Sepsis was not recognized in 32 of these 54 cases (59%). Multivariate binary logistic regression analysis revealed that higher systolic blood pressure (p <br

Additional file 1: of Sepsis recognition in the emergency department – impact on quality of care and outcome?

Baseline characteristics of all included patients (table). (PDF 169 kb

Additional file 5: of Sepsis recognition in the emergency department – impact on quality of care and outcome?

Death-censored length of hospital stay according to sepsis recognition (Sepsis-3 definitions). Kaplan-Meier curves with log-rank testing showing the length of stay in recognized (n = 17) and unrecognized (n = 32) patients with sepsis. (PDF 117 kb

Additional file 3: of Sepsis recognition in the emergency department – impact on quality of care and outcome?

Univariate and multivariate regression analysis for impact on missing sepsis diagnoses (table). (PDF 88 kb