Developing a digital data collection platform to measure the prevalence of sepsis in Wales

Sharif, Ben; Lundin, Robert M; Morgan, P.; Hall, Judith Elizabeth; Dhadda, Amrit; Mann, C.; Donoghue, Danielle; Brownlow, Emma; Hill, Francesca; Carr, Grace; Turley, Hannah; Hassall, James; Atkinson, Michael; Jones, Matthew; Martin, Rhodri; Rollason, Sarah; Ibrahim, Yousef; Kopczynska, Maja; Szakmány, Tamás

doi:10.1093/jamia/ocv208

Cited by 20 publications

(26 citation statements)

References 6 publications

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“…The strengths of our work include the use of robust, previously published data collection methodology tested over subsequent studies, and the wide participation of centres . We prospectively collected data on patients where the clinical teams suspected infection, hence we were able to test the real‐life utility of the new sepsis definition and proposed clinical tools and compared its performance with the already implemented SEPSIS‐1 criteria.…”

Section: Discussionmentioning

confidence: 99%

“…We provided key study information through emails, face‐to‐face training and online video tutorials, which included the protocol, answers to key questions and description of the electronic case report form (eCRF) on the electronic tablets. We previously published the details of the digital data collection platform developed for this study .…”

Section: Methodsmentioning

confidence: 99%

“…We previously reported the results of a point‐prevalence feasibility study and subsequent study of all Welsh centres using the 1992 International Consensus Criteria for sepsis (SEPSIS‐1), using electronic data collection and real‐time data monitoring . We found that 4% of hospitalised patients had sepsis, half of whom had significant organ dysfunction (severe sepsis).…”

Section: Introductionmentioning

confidence: 99%

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Defining sepsis on the wards: results of a multi‐centre point‐prevalence study comparing two sepsis definitions

et al. 2017

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Our aim was to prospectively determine the predictive capabilities of SEPSIS-1 and SEPSIS-3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24-h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS-1 definition, 212 patients had sepsis. When using the SEPSIS-3 definitions with Sequential Organ Failure Assessment (SOFA) score ≥ 2, there were 272 septic patients, whereas with quickSOFA score ≥ 2, 50 patients were identified. For the prediction of primary outcome, SEPSIS-1 criteria had a sensitivity (95%CI) of 65% (54-75%) and specificity of 47% (41-53%); SEPSIS-3 criteria had a sensitivity of 86% (76-92%) and specificity of 32% (27-38%). SEPSIS-3 and SEPSIS-1 definitions were associated with a hazard ratio (95%CI) 2.7 (1.5-5.6) and 1.6 (1.3-2.5), respectively. Scoring system discrimination evaluated by receiver operating characteristic curves was highest for Sequential Organ Failure Assessment score (0.69 (95%CI 0.63-0.76)), followed by NEWS (0.58 (0.51-0.66)) (p < 0.001). Systemic inflammatory response syndrome criteria (0.55 (0.49-0.61)) and quickSOFA score (0.56 (0.49-0.64)) could not predict outcome. The SEPSIS-3 definition identified patients with the highest risk. Sequential Organ Failure Assessment score and NEWS were better predictors of poor outcome. The Sequential Organ Failure Assessment score appeared to be the best tool for identifying patients with high risk of death and sepsis-induced organ dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Defining sepsis on the wards: results of a multi‐centre point‐prevalence study comparing two sepsis definitions

et al. 2017

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“…Key study information was provided through e-mails, face-to-face training and online video tutorials, which included the protocol, answers to key questions and description of the electronic case report form (eCRF). The details of the digital data collection platform developed for this study have been published previously [11]. Medical students working in pairs to ensure data validity and appropriate clinical knowledge, acted as data collectors, using tablets for electronic data collection and transfer.…”

Section: Methodsmentioning

confidence: 99%

Sepsis Prevalence and Outcome on the General Wards and Emergency Departments in Wales: Results of a Multi-Centre, Observational, Point Prevalence Study

et al. 2016

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Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis). There were 5317 in-patients in the 24-hour study period. Data were returned on 1198 digital data collection forms on patients with NEWS≥3 of which 87 were removed, leaving 1111 for analysis. 146 patients had sepsis and 144 patients had severe sepsis. Combined prevalence of sepsis and severe sepsis was 5.5% amongst all in-patients. Patients with sepsis had significantly higher NEWS scores (3 IQR 3–4 for non-sepsis and 4 IQR 3–6 for sepsis patients, respectively). Common organ dysfunctions in severe sepsis were hypoxia (47%), hypoperfusion (40%) and acute kidney injury (25%). Mortality at 90 days was 31% with a median (IQR) hospital free stay of 78 (36–85) days. Screening for sepsis, referral to Critical Care and completion of Sepsis 6 bundle was low: 26%, 16% and 12% in the sepsis group. Multivariable logistic regression analysis identified higher National Early Warning Score, diabetes, COPD, heart failure, malignancy and current or previous smoking habits as independent variables suggesting the diagnosis of sepsis. We observed that sepsis is more prevalent in the general ward and ED than previously suggested before and that screening and effective treatment for sepsis and severe sepsis is far from being operationalized in this environment, leading to high 90 days mortality.

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“…Data analysis. Questionnaire data were collected using an Android tablet running Open Data Kit software 61 .…”

Section: Questionnairementioning

confidence: 99%

Patterns of Rift Valley fever virus seropositivity in domestic ruminants in central South Africa four years after a large outbreak

Ngoshe

Avenant

Rostal

et al. 2020

Sci Rep

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Rift Valley fever (RVf) is a mosquito-borne viral zoonosis showing complex epidemiological patternsthat are poorly understood in South Africa. Large outbreaks occur in the central interior at long, irregular intervals, most recently in 2010-2011; however, the level of herd immunity of ruminant livestock, a key determinant of outbreaks, is unknown. During 2015-2016 a cross-sectional study on 234 randomly-selected farms investigated the prevalence, patterns of, and factors associated with, antibodies to RVF virus (RVFV) in livestock in an area heavily affected by that outbreak. A RVFV inhibition ELISA was used to screen 977 cattle, 1,549 sheep and 523 goats and information on potential risk factors was collected using a comprehensive questionnaire. the estimated RVfV seroprevalence, adjusted for survey design, was 42.9% in cattle, 28.0% in sheep and 9.3% in goats, showing a high degree of farm-level clustering. Seroprevalence increased with age and was higher on private vs. communal land, on farms with seasonal pans (temporary, shallow wetlands) and perennial rivers and in recently vaccinated animals. Seropositivity amongst unvaccinated animals born after the last outbreak indicates likely viral circulation during the post-epidemic period. the current level of herd immunity in livestock may be insufficient to prevent another large outbreak, should suitable conditions recur.Rift Valley fever (RVF) is an arthropod-borne viral zoonosis caused by RVF virus (RVFV), a member of the Phlebovirus genus, family Phenuiviridae of the recently established order Bunyavirales 1 . RVF is endemic primarily in sub-Saharan Africa but has crossed several barriers including the Sahara to Egypt, the Red Sea to the Arabian Peninsula and the Indian Ocean to the Comoros, Mayotte and Madagascar 2-4 . Spread through infected animals and mosquitoes to countries where the disease is not endemic is increasingly possible, with more frequent export of livestock from Africa to other countries and the presence of known or potentially competent vectors in those countries 4,5 . RVFV causes sporadic outbreaks with high morbidity and mortality, characterized by abortion storms and high mortalities in neonatal sheep, cattle and goats 6,7 . Human infection generally occurs concurrently with disease outbreaks in domestic ruminants 2,5,8 , where humans work or live in close contact with livestock.Outbreaks tend to occur following above average rainfall and localized flooding 9 . These climatic conditions favour breeding of floodwater mosquitoes that are the proposed maintenance vectors of this virus via transovarial transmission 10 . The floodwater mosquitoes considered to be vectors on the interior plateau of South Africa are those in the Aedes subgenera Ochlerotatus and Neomelaniconion 11 . Outbreaks may then be amplified by epidemic vectors, of which Culex theileri is considered the most important on the interior plateau 12 . Risk factor studies conducted during and after outbreaks in both humans and animals have identified several other environmental, ...

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Developing a digital data collection platform to measure the prevalence of sepsis in Wales

Abstract: Our platform allowed us to measure, for the first time, the prevalence of sepsis in Wales over 24 hours.

Cited by 20 publications

References 6 publications

Defining sepsis on the wards: results of a multi‐centre point‐prevalence study comparing two sepsis definitions

Defining sepsis on the wards: results of a multi‐centre point‐prevalence study comparing two sepsis definitions

Sepsis Prevalence and Outcome on the General Wards and Emergency Departments in Wales: Results of a Multi-Centre, Observational, Point Prevalence Study

Patterns of Rift Valley fever virus seropositivity in domestic ruminants in central South Africa four years after a large outbreak

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