The Available Criteria for Different Sepsis Scoring Systems in the Emergency Department-A Retrospective Assessment.

Abstract

ObjectiveThe goal of the study was to assess the criteria availability of eight sepsis scoring methods within 6 hours of triage in the emergency department (ED).DesignRetrospective data analysis study.SettingED of MedStar Washington Hospital Center (MWHC), a 912-bed urban, tertiary hospital.PatientsAdult (age ≥ 18 years) patients presenting to the MWHC ED between June 1, 2017 and May 31, 2018 and admitted with a diagnosis of severe sepsis with or without shock.Main Outcomes MeasuredAvailability of sepsis scoring criteria of eight different sepsis scoring methods at three time points—0 Hours (T0), 3 Hours (T1) and 6 Hours (T2) after arrival to the ED.ResultsA total of 50 charts were reviewed, which included 23 (46%) males and 27 (54%) females. Forty-eight patients (96%) were Black or African American. Glasgow Coma Scale was available for all 50 patients at T0. Vital signs, except for temperature, were readily available (>90%) at T0. The majority of laboratory values relevant for sepsis scoring criteria were available (>90%) at T1, with exception to bilirubin (66%) and creatinine (80%). NEWS, PRESEP and qSOFA had greater than 90% criteria availability at triage. SOFA and SIRS consistently had the least percent of available criteria at all time points in the ED.ConclusionThe availability of patient data at different time points in a patient’s ED visit suggests that different scoring methods could be utilized to assess for sepsis as more patient information becomes available.