Keywords reflecting sepsis presentation based on mode of emergency department arrival: a retrospective cross-sectional study

International Journal of Emergency Medicine

Hans Järnbert-Pettersson¹  Lisa Kurland²  Anna Su³  Jennifer Short⁴  Ulrika Margareta Wallgren⁵  Eric Larsson⁶ 

[1] Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Department of Medical Sciences, Örebro University, Campus USÖ, Södra Grev Rosengatan 32, 701 12, Örebro, Sweden;Department of Emergency Medicine, Örebro University Hospital, Södra Grev Rosengatan 18, 703 62, Örebro, Sweden;Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Department of Surgery, Sankt Göran Hospital, Sankt Göransplan 1, 112 19, Stockholm, Sweden;Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Department of Urology, Linköping University Hospital, 581 85, Linköping, Sweden;Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden;Fisksätra Vårdcentral (Primary Health Care Center), Fisksätra torg 20, 133 41, Saltsjöbaden, Sweden;Department of Medical Sciences, Örebro University, Campus USÖ, Södra Grev Rosengatan 32, 701 12, Örebro, Sweden;Department of Medical Sciences, Örebro University, Campus USÖ, Södra Grev Rosengatan 32, 701 12, Örebro, Sweden;

关键词: Emergency medical service;    Emergency care;    Emergency department;    Sepsis;    Symptoms;   

DOI  :  10.1186/s12245-021-00396-z

来源: Springer

【 摘 要 】

BackgroundCurrent sepsis screening tools are predominantly based on vital signs. However, patients with serious infections frequently present with normal vital signs and there has been an increased interest to include other variables such as symptoms in screening tools to detect sepsis. The majority of patients with sepsis arrive to the emergency department by emergency medical services. Our hypothesis was that the presentation of sepsis, including symptoms, may differ between patients arriving to the emergency department by emergency medical services and patients arriving by other means. This information is of interest to adapt future sepsis screening tools to the population in which they will be implemented. The aim of the current study was to compare the prevalence of keywords reflecting the clinical presentation of sepsis based on mode of arrival among septic patients presenting to the emergency department.MethodsRetrospective cross-sectional study of 479 adult septic patients. Keywords reflecting sepsis presentation upon emergency department arrival were quantified and analyzed based on mode of arrival, i.e., by emergency medical services or by other means. We adjusted for multiple comparisons by applying Bonferroni-adjusted significance levels for all comparisons. Adjustments for age, gender, and sepsis severity were performed by stratification. All patients were admitted to the emergency department of Södersjukhuset, Stockholm, and discharged with an ICD-10 code compatible with sepsis between January 1, and December 31, 2013.Results“Abnormal breathing” (51.8% vs 20.5%, p value < 0.001), “abnormal circulation” (38.4% vs 21.3%, p value < 0.001), “acute altered mental status” (31.1% vs 13.1%, p value < 0.001), and “decreased mobility” (26.1% vs 10.7%, p value < 0.001) were more common among patients arriving by emergency medical services, while “pain” (71.3% vs 40.1%, p value < 0.001) and “risk factors for sepsis” (50.8% vs 30.8%, p value < 0.001) were more common among patients arriving by other means.ConclusionsThe distribution of most keywords related to sepsis presentation was similar irrespective of mode of arrival; however, some differences were present. This information may be useful in clinical decision tools or sepsis screening tools.

【 授权许可】

CC BY