sepsis alert

BACKGROUND: First medical contact for patients with sepsis often initiates in the prehospital setting, yet limited studies have explored the EMS sepsis recognition-mortality relationship. Racial and ethnic minority patients often have worse sepsis outcomes, yet the role of prehospital recognition in this inequity has not been explored. Our objective was to describe prehospital sepsis recognition and hospital mortality, with analysis by patient race and ethnicity. METHODS: Using linked EMS and hospital records from the 2021 ESO Data Collaborative, we retrospectively analyzed 9-1-1 EMS transports for adult patients with emergency department ICD-10 sepsis diagnosis codes...

BACKGROUND: General practitioners (GPs) often assess patients with acute infections. It is challenging for GPs to recognize patients needing immediate hospital referral for sepsis while avoiding unnecessary referrals. This study aimed to predict adverse sepsis-related outcomes from telephone triage information of patients presenting to out-of-hours GP cooperatives. METHODS: A retrospective cohort study using linked routine care databases from out-of-hours GP cooperatives, general practices, hospitals and mortality registration...

OBJECTIVES: To determine if a real-time monitoring system with automated clinician alerts improves 3-hour sepsis bundle adherence. DESIGN: Prospective, pragmatic clinical trial. Allocation alternated every 7 days. SETTING: Quaternary hospital from December 1, 2020 to November 30, 2021. PATIENTS: Adult emergency department or inpatients meeting objective sepsis criteria triggered an electronic medical record (EMR)-embedded best practice advisory...

BACKGROUND: Sepsis is a life-threatening condition caused by a dysregulated response to infection, affecting millions of people worldwide. Early diagnosis and treatment are critical for managing sepsis and reducing morbidity and mortality rates. MATERIALS AND METHODS: A systematic design approach was employed to build a model that predicts sepsis, incorporating clinical feedback to identify relevant data elements. XGBoost was utilized for prediction, and interpretability was achieved through the application of Shapley values...

BACKGROUND: This study aimed to analyze the clinical course of a newborn with congenital scrub typhus caused by vertical transmission and explore early diagnosis and treatment strategies. The clinical data of the neonate were retrospectively analyzed and the related literature was reviewed. CASE PRESENTATION: The newborn was a full-term one, with a good Apgar score at birth. The neonate had apnea at 3 h of life, requiring NICU care and IV antibiotics (piperacillin) for suspected sepsis...

OBJECTIVE: To evaluate the prevalence, risk factors, and clinical impact of delays in second doses of antibiotics in patients with sepsis. DESIGN: Single-center, retrospective, observational study. SETTING: Large teaching hospital. PATIENTS: Adult patients who triggered an electronic sepsis alert in the emergency department (ED), received ≥2 doses of vancomycin or an antipseudomonal beta-lactam, and were discharged with an ICD-10 sepsis code...

Burn injuries are the most frequent injuries in the world, with a death rate of 2.3-3.6%. Children and people of working age constitute 85-90% of the burn cases. Burn injury results in metabolic problems, a generalized inflammatory response, inefficient energy use, and other physiological alternations that may cause organ and system dysfunction and sepsis. Sepsis is mostly caused by multiple organ failures and has unique characteristics in burn injuries, which make it the most dangerous complication of burn injuries...

BACKGROUND: Neonatal sepsis is a major determinant of neonatal mortality. There is a scarcity of evidence-based guidelines for the duration of antibiotics in culture-positive sepsis. OBJECTIVES: The aim of this study was to compare the efficacy of 10- and 14-day antibiotic therapies in the management of culture-positive neonatal sepsis. METHODS: This randomized controlled trial was conducted in the neonatal intensive care unit of a tertiary care center among the neonates suffering from culture-positive sepsis (with signs of clinical remission on day 9 of antibiotic) between January 2023 and May 2023...

Mycobacterium abscessus (M.abscessus), which is from the group of non-tuberculosis mycobacteria and is widely found in the natural environment, has been reported with increasing frequency as the causative agent of various infections; especially in the lower respiratory tract and in immuncompromised people. In this report, a case of M.abscessus, which developed tubular adenoma, pancytopenia and sepsis on the basis of chronic renal failure (CRF) was diagnosed by suspecting the causative agent in the Gram stain examination prepared from blood culture, was presented...

BACKGROUND: Heart rate (HR) abnormalities are common in critically ill patients, but the significance of HR fluctuation in sepsis remains unclear. We aimed to assess the association of HR fluctuation with intensive care unit (ICU) mortality, hospital mortality, and 28-day mortality in patients with sepsis and identify the cutoff value of HR fluctuation associated with the lowest risk of death. METHODS: We conducted a retrospective cohort study using the medical information mart for the intensive care IV database...

OBJECTIVE: Surveillance algorithms that predict patient decompensation are increasingly integrated with clinical workflows to help identify patients at risk of in-hospital deterioration. This scoping review aimed to identify the design features of the information displays, the types of algorithm that drive the display, and the effect of these displays on process and patient outcomes. MATERIALS AND METHODS: The scoping review followed Arksey and O'Malley's framework...

Background: Sepsis is the leading cause of mortality among hospitalized patients in our health care system and has been the target of major international initiatives such as the Surviving Sepsis Campaign championed by the Society of Critical Care Medicine and Get Ahead of Sepsis led by the Centers for Disease Control and Prevention. Methods: Our institution has strived to improve outcomes for patients by implementing a novel suite of integrated clinical decision support tools driven by a predictive learning algorithm in the electronic health record...

PURPOSE: To determine whether a novel intervention improves the adherence to guideline-based preventive measures in asplenic patients at risk of post-splenectomy sepsis (PSS). METHODS: We used a prospective controlled, two-armed historical control group design to compare a novel, health action process approach (HAPA)-based telephonic intervention involving both patients and their general practitioners to usual care. Eligible patients were identified in cooperation with the insurance provider AOK Baden-Wuerttemberg, Germany...

To examine whether Heart rate Interval based Rapid Alert (HIRA) score derived from a combination model of Heart rate variability (HRV) and Modified Early Warning Score (MEWS) is a surrogate for the detection of Acute Respiratory Failure (ARF) in critically ill sepsis patients.

Approach : Retrospective HRV analysis of sepsis patients admitted to Emory Healthcare Intensive Care Unit (ICU) was performed between sepsis-related ARF and sepsis controls without ARF. HRV measures such as time domain, frequency domain, and nonlinear measures were analyzed up to 24 hours after patient admission, 1 hour before the onset of ARF, and a random event time in the sepsis controls...

Streptococcus agalactiae , also known as Group B Streptococcus (GBS), is a common pathogen in the neonatal period, causing meningitis and sepsis. In non-pregnant adults it is an unusual cause of meningitis. We report about an elderly female with several risk factors for invasive GBS infection who developed GBS meningoencephalitis one month after treatment for COVID-19 upper respiratory tract infection. The patient presented with mania, and the classic triad of headache, neck stiffness, and fever was absent which contributed to the delay in diagnosis...

Neonatal sepsis is a bacterial bloodstream infection leading to severe clinical manifestations frequently associated with death or irreversible long-term deficits. Antibiotics are the drug of choice to treat sepsis, regardless of age. In neonates, the lack of reliable criteria for a definite diagnosis and the supposition that an early antibiotic administration could reduce sepsis development in children at risk have led to a relevant antibiotic overuse for both prevention and therapy. The availability of biomarkers of neonatal sepsis that could alert the physician to an early diagnosis of neonatal sepsis could improve the short and long-term outcomes of true sepsis cases and reduce the indiscriminate and deleterious use of preventive antibiotics...

No abstract text is available yet for this article.

BACKGROUND: Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is an acute, self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious cardiovascular complications, with a 25% incidence of coronary artery aneurysms. Periton-Sillar abscesses are a rare symptom of KD and is easily misdiagnosed at its early stages. CASE SUMMARY: A 5-year-old boy who presented to a community hospital with a 3-d fever, difficulty in opening his mouth, and neck pain and was originally treated for throat infection without improvement...

INTRODUCTION: According to excising findings, if the emergency management system (EMS) operation will be developed, the survival outcome of sepsis patients might improve. This study aimed to evaluate the pre-hospital associated factors of survival in sepsis patients. METHODS: This retrospective cohort study was conducted on patients diagnosed with sepsis, coded with the Thailand emergency medical triage protocol and criteria-based dispatch symptom group 17. Information on the 30-day survival rate of patients was obtained from the electronic medical records...

BACKGROUND: Following development and validation of a sepsis prediction model described in a companion article, we aimed to use quality improvement and safety methodology to guide the design and deployment of clinical decision support (CDS) tools and clinician workflows to improve pediatric sepsis recognition in the inpatient setting. METHODS: CDS tools and sepsis huddle workflows were created to implement an electronic health record-based sepsis prediction model...