Abstract
BackgroundThe development of sepsis risk prediction models and treatment guidelines has largely been based on patients presenting in the emergency department (ED) with severe sepsis or septic shock. Therefore, in this study we investigated which patient characteristics might identify patients with an adverse outcome in a heterogeneous group of patients presenting with uncomplicated sepsis to the emergency department (ED).FindingsWe performed a retrospective cohort analysis of all ED patients presenting with uncomplicated sepsis in a large teaching hospital during a 3-month period. During this period, 70 patients fulfilled the criteria of uncomplicated sepsis. Eight died in the hospital. Non-survivors were characterized by a higher abbreviated Mortality in Emergency Department Sepsis (MEDS) score (7.2 ± 3.4 vs. 4.8 ± 2.9, p = 0.03) and a lower Hb (6.6 ± 1.2 vs. 7.7 ± 1.4, p = 0.03), and they used beta-blockers more often (75% vs. 19%, p < 0.01).ConclusionsNon-survivors of uncomplicated sepsis had on average a higher abbreviated MEDS score, a lower hemoglobin (Hb) and more often used β-blockers compared to survivors. Early identification of these factors might contribute to optimization of sepsis treatment for this patient category and thereby prevent disease progression to severe sepsis or septic shock.
Highlights
Sepsis remains an ongoing challenge in medicine
Research over the past years has mainly been focused on the early identification and treatment of patients with advanced stage sepsis: Risk prediction models and especially treatment guidelines for sepsis at the emergency department (ED) are largely derived from patients presenting with severe sepsis or septic shock, and it remains unclear whether the same risk prediction models are applicable for patients presenting to the ED with uncomplicated sepsis [3,4,5]
101 patients were diagnosed with sepsis, of which 31 had a severe sepsis or septic shock, and 70 had an uncomplicated sepsis
Summary
Sepsis remains an ongoing challenge in medicine. Mortality rates depend on the sepsis stage and co-morbidity and range from 4.1% in patients with uncomplicated sepsis to as high as 50% in patients with septic shock [1]. Research over the past years has mainly been focused on the early identification and treatment of patients with advanced stage sepsis: Risk prediction models and especially treatment guidelines for sepsis at the ED are largely derived from patients presenting with severe sepsis or septic shock, and it remains unclear whether the same risk prediction models are applicable for patients presenting to the ED with uncomplicated sepsis [3,4,5]. The development of sepsis risk prediction models and treatment guidelines has largely been based on patients presenting in the emergency department (ED) with severe sepsis or septic shock. In this study we investigated which patient characteristics might identify patients with an adverse outcome in a heterogeneous group of patients presenting with uncomplicated sepsis to the emergency department (ED)
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