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Keywords reflecting sepsis presentation based on mode of emergency department arrival: a retrospective cross-sectional study
Örebro University, School of Medical Sciences. Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Stockholm, Sweden; Fisksätra Vårdcentral (Primary Health Care Center), Saltsjöbaden, Sweden.
Department of Medical Sciences, Örebro University, Campus USÖ, Örebro, Sweden.
Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Stockholm, Sweden; Department of Surgery, Sankt Göran Hospital, Stockholm, Sweden .
Department of Clinical Science and Education, Karolinska Institutet, Söderssjukhuset, Stockholm, Sweden; Department of Urology, Linköping University Hospital, Linköping, Sweden.
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2021 (English)In: International Journal of Emergency Medicine, ISSN 1865-1372, E-ISSN 1865-1380, Vol. 14, no 1, article id 78Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Current 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.

METHODS: Retrospective 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.

CONCLUSIONS: The 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.

Place, publisher, year, edition, pages
Springer-Verlag New York, 2021. Vol. 14, no 1, article id 78
Keywords [en]
Emergency care, Emergency department, Emergency medical service, Sepsis, Symptoms
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:oru:diva-96131DOI: 10.1186/s12245-021-00396-zISI: 000732945900003PubMedID: 34930114Scopus ID: 2-s2.0-85121423857OAI: oai:DiVA.org:oru-96131DiVA, id: diva2:1622398
Note

Funding agencies:

Stockholm city council

Section of Emergency Medicine, Södersjukhuset

Örebro University

Available from: 2021-12-22 Created: 2021-12-22 Last updated: 2024-01-16Bibliographically approved

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Wallgren, Ulrika M.Kurland, Lisa

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