Improvement of sepsis identification through multi-year comparison of sepsis and early warning scores.
Am J Emerg Med
; 51: 239-247, 2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-34775198
ABSTRACT
BACKGROUND:
Sepsis remains a leading cause of death among inpatients. Scoring systems designed to identify inpatients with sepsis currently have limited effectiveness. This single institution, retrospective, case-control study aims to improve sepsis decision support tool performance using temporal analyses of sepsis-specific and general deterioration scoring systems.METHODS:
Sequential Organ Failure Assessment, National Early Warning Scores (NEWS), and Modified Early Warning Scores were calculated using four years of inpatient data. Sensitivity and specificity analyses compared performance of each score, calculated as a function of both various score cut-off values and time before sepsis diagnosis using established proxies for identifying clinical suspicion for sepsis.RESULTS:
NEWS had the best sensitivity-specificity performance (AUROC 82.7) when examining various score cutoffs and time intervals during which diagnosis criteria were met. Comparison of false positives/negatives with various score thresholds showed a low rate of false positives with a NEWS of 7. Score trends in the hours leading up to sepsis criteria being met showed a marked increase for the sepsis group while for the cases there was a decrease during a comparable period.CONCLUSIONS:
Temporal analyses of scores for patients coded as having sepsis provides novel insights into patterns of deterioration. The methods and results provide practical details demonstrating how general deterioration algorithms can be used to alert trained responders to potential cases of sepsis to improve sepsis recognition and treatment opportunities.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sepse
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Escores de Disfunção Orgânica
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Escore de Alerta Precoce
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Am J Emerg Med
Ano de publicação:
2022
Tipo de documento:
Article