Characteristics and outcomes of patients admitted for suspected sepsis

Abstract

Structured sepsis screening and management tools are associated with improvements in processes of care. Evaluating effects on clinical outcomes is challenged by the potential limitation of capturing a broader group of patients with less severe illness. The aim was to determine the true incidence of sepsis and septic shock and outcomes among patients admitted for suspected sepsis in an adult tertiary hospital Emergency Department (ED). A retrospective observational study identified patients admitted with suspected sepsis. Patients were subsequently classified into four groups: infection, sepsis, septic shock and non-infection diagnosis using standardised objective criteria. Baseline characteristics, processes of care, and clinical outcomes were compared between groups. Five hundred and ninety-five patients were included. These were classified as 210 (35%) with infection, 267 (45%) with sepsis, 58 (10%) with septic shock, and 60 (10%) with a non-infective primary diagnosis. Rates of organ support, intensive care admission and mortality varied significantly between groups. An ED sepsis screening program identifies a range of patients, with 45% not meeting clinical sepsis criteria. Measuring the effectiveness of sepsis recognition tools on clinical outcomes requires standardised confirmation of sepsis to inform quality-of-care measures, benchmarking, and resource allocation.