Identifying Patients With Sepsis on the Hospital Wards

被引:87
作者
Bhattacharjee, Poushali [1 ]
Edelson, Dana P. [1 ]
Churpek, Matthew M. [1 ]
机构
[1] Univ Chicago, Dept Med, Chicago, IL 60637 USA
基金
美国医疗保健研究与质量局;
关键词
clinical decision support systems; sepsis; SIRS; SOFA; INTERNATIONAL CONSENSUS DEFINITIONS; EARLY WARNING SCORE; SEPTIC SHOCK; EARLY IDENTIFICATION; SURVIVING SEPSIS; SCREENING TOOL; CARE-UNIT; PREDICTION; VALIDATION; GUIDELINES;
D O I
10.1016/j.chest.2016.06.020
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Sepsis contributes to up to half of all deaths in hospitalized patients, and early interventions, such as appropriate antibiotics, have been shown to improve outcomes. Most research has focused on early identification and treatment of patients with sepsis in the ED and the ICU; however, many patients acquire sepsis on the general wards. The goal of this review is to discuss recent advances in the detection of sepsis in patients on the hospital wards. We discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening patients with sepsis, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick sepsis-related organ failure assessment (qSOFA) score. Challenges specific to detecting sepsis on the wards are discussed, and future directions that use big data approaches and automated alert systems are highlighted.
引用
收藏
页码:898 / 907
页数:10
相关论文
共 56 条
[1]
Clinical Decision Support for Early Recognition of Sepsis [J].
Amland, Robert C. ;
Hahn-Cover, Kristin E. .
AMERICAN JOURNAL OF MEDICAL QUALITY, 2016, 31 (02) :103-110
[2]
Amland Robert C, 2015, JRSM Open, V6, p2054270415609004, DOI 10.1177/2054270415609004
[3]
Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care [J].
Angus, DC ;
Linde-Zwirble, WT ;
Lidicker, J ;
Clermont, G ;
Carcillo, J ;
Pinsky, MR .
CRITICAL CARE MEDICINE, 2001, 29 (07) :1303-1310
[4]
[Anonymous], 2008, INTENS CARE MED, DOI [DOI 10.1007/s00134-007-0934-2, DOI 10.1007/s00134-008-1040-9]
[5]
[Anonymous], 2002, ACTION DEMANDED WORL
[6]
Antonelli M, 2016, SURVIVING SEPSIS CAM
[7]
Improved Sensitivity for Molecular Detection of Bacterial and Candida Infections in Blood [J].
Bacconi, Andrea ;
Richmond, Gregory S. ;
Baroldi, Michelle A. ;
Laffler, Thomas G. ;
Blyn, Lawrence B. ;
Carolan, Heather E. ;
Frinder, Mark R. ;
Toleno, Donna M. ;
Metzgar, David ;
Gutierrez, Jose R. ;
Massire, Christian ;
Rounds, Megan ;
Kennel, Natalie J. ;
Rothman, Richard E. ;
Peterson, Stephen ;
Carroll, Karen C. ;
Wakefield, Teresa ;
Ecker, David J. ;
Sampath, Rangarajan .
JOURNAL OF CLINICAL MICROBIOLOGY, 2014, 52 (09) :3164-3174
[8]
Pyocalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations [J].
Becker, Kenneth L. ;
Snider, Richard ;
Nylen, Eric S. .
CRITICAL CARE MEDICINE, 2008, 36 (03) :941-952
[9]
Bhattacharjee P, 2016, J HOSP MED S1, V11
[10]
BIHARI DJ, 1990, J ANTIMICROB CHEMOTH, V25, P1