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: Th...

Authors: Morr, Marius
Lukasz, Alexander
Rübig, Eva Christina
Pavenstädt, Hermann
Kümpers, Philipp
Division/Institute:FB 05: Medizinische Fakultät
Document types:Article
Media types:Text
Publication date:2017
Date of publication on miami:04.04.2018
Modification date:16.04.2019
Edition statement:[Electronic ed.]
Subjects:Sepsis; Severe sepsis; Sepsis recognition; Infection; Emergency department; Quality of care
DDC Subject:610: Medizin und Gesundheit
License:CC BY 4.0
Language:English
Notes:BMC Emergency Medicine 17 (2017) 11, 1-8
Funding:Finanziert durch den Open-Access-Publikationsfonds 2017 der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF document
URN:urn:nbn:de:hbz:6-69109643079
Permalink:http://nbn-resolving.de/urn:nbn:de:hbz:6-69109643079
Other Identifiers:DOI: 10.1186/s12873-017-0122-9
Digital documents:2017_artikel_kuempers.pdf

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