Evolving sepsis definitions and their impact on Acute Medical Units

Thompson, Andrew; Stevens, Mitali; Collin, I; Wennike, Nic

doi:10.52964/amja.0648

Cited by 5 publications

(1 citation statement)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Criticism regarding the use of SOFA outside of the ICU stems from its complexity and unfamiliarity among noncritical care practitioners (25). Further obstacles to using SOFA on the general wards and ED include the need for laboratory test results for platelets, bilirubin, and creatinine, which creates delay in the diagnosis of sepsis (26).…”

Section: Discussionmentioning

confidence: 99%

The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies

Unwin

Kopczynska

Pugh

et al. 2021

Critical Care Explorations

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies

Unwin

Kopczynska

Pugh

et al. 2021

Critical Care Explorations

View full text Add to dashboard Cite

show abstract

Sepsis recognition tools in acute ambulatory care: associations with process of care and clinical outcomes in a service evaluation of an Emergency Multidisciplinary Unit in Oxfordshire

et al. 2018

View full text Add to dashboard Cite

ObjectiveTo assess the performance of currently available sepsis recognition tools in patients referred to a community-based acute ambulatory care unit.DesignService evaluation of consecutive patients over a 4-month period.SettingCommunity-based acute ambulatory care unit.Data collection and outcome measuresObservations, blood results and outcome data were analysed from patients with a suspected infection. Clinical features at first assessment were used to populate sepsis recognition tools including: systemic inflammatory response syndrome (SIRS) criteria, National Early Warning Score (NEWS), quick Sequential Organ Failure Assessment (qSOFA) and National Institute for Health and Care Excellence (NICE) criteria. Scores were assessed against the clinical need for escalated care (use of intravenous antibiotics, fluids, ongoing ambulatory care or hospital treatment) and poor clinical outcome (all-cause mortality and readmission at 30 days after index assessment).ResultsOf 533 patients (median age 81 years), 316 had suspected infection with 120 patients requiring care escalated beyond simple community care. SIRS had the highest positive predictive value (50.9%, 95% CI 41.6% to 60.3%) and negative predictive value (68.9%, 95% CI 62.6% to 75.3%) for the need for escalated care. Both NEWS and SIRS were better at predicting the need for escalated care than qSOFA and NICE criteria in patients with suspected infection (all P<0.001). While new-onset confusion predicted the need for escalated care for infection in patients ≥85 years old (n=114), 23.7% of patients ≥85 years had new-onset confusion without evidence for infection.ConclusionsAcute ambulatory care clinicians should use caution in applying the new NICE endorsed criteria for determining the need for intravenous therapy and hospital-based location of care. NICE criteria have poorer performance when compared against NEWS and SIRS and new-onset confusion was prevalent in patients aged ≥85 years without infection.

show abstract

Using sepsis scores in emergency department and ward patients

Steele

Hill

2019

Br J Hosp Med

View full text Add to dashboard Cite

Sepsis-3, published in 2016, defined sepsis as ‘life-threatening organ dysfunction caused by a dysregulated host response to infection’. Instead of systemic inflammatory response syndrome (SIRS), calculating the Sequential Organ Failure Assessment (SOFA) score was recommended. The complexity of SOFA also led to the introduction of quick SOFA (qSOFA) as a bedside tool. The simultaneous removal of SIRS and introduction of qSOFA belies their significant differences, with SIRS having a high sensitivity but very low specificity, and qSOFA being very specific for a poor outcome, but having a lower sensitivity than SIRS. In the UK, the variables within qSOFA are collected on a regular and repeated basis, along with additional variables, as part of the National Early Warning Score (NEWS). A knowledge of SIRS, qSOFA and NEWS is of value in assessing patients with suspected sepsis, as discussed in this article.

show abstract

Evolving sepsis definitions and their impact on Acute Medical Units

Cited by 5 publications

References 3 publications

The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies

The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies

Sepsis recognition tools in acute ambulatory care: associations with process of care and clinical outcomes in a service evaluation of an Emergency Multidisciplinary Unit in Oxfordshire

Using sepsis scores in emergency department and ward patients

Contact Info

Product

Resources

About