Background: There are currently several different definitions for sepsis. This study looked at what proportion of acute medical admissions were identified by the different definitions, what correlation they have, and how many patients would require a review with results in 1 hour.
Methods: Data on 212 admissions was collected, on time of admission and review, and number of patients with sepsis by each diagnostic criteria calculated.
Results: The NICE criteria identified 69% of admissions as requiring review within one hour, compared to 6% with qSOFA and 18% with previous sepsis definitions. The mean time to review was 1hr 18min, and only 50% of patients meeting the NICE criteria were reviewed within one hour.
Conclusions: The proposed NICE guidance will be challenging to implement with current resources.
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References
- Kaukonen KM, Bailey M, Pilcher D et al. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med 2015; 372(17):1629-38.
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- NICE draft guideline Sepsis: the recognition, diagnosis and management of sepsis. https://www.nice.org.uk/guidance/GIDCGWAVE0686/documents/draft-guideline-2
- Commissioning for Quality and Innovation (CQUIN) 2015/16 https://www.england.nhs.uk/wp-content/uploads/2015/03/9-cquin-guid-2015-16.pdf
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- Churpek MM, Snyder A, Han X, et al. qSOFA, SIRS, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients Outside the ICU. Am J Respir Crit Care Med. 2016 Published Online Sept 20, 2016
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