Outcomes of Patients with Sepsis in a Pediatric Emergency Department after Automated Sepsis Screening

被引:3
|
作者
Eisenberg, Matthew A. [1 ,3 ]
Freiman, Eli [1 ,3 ]
Capraro, Andrew [1 ,3 ]
Madden, Kate [2 ,4 ]
Monuteaux, Michael C. [1 ,3 ]
Hudgins, Joel [1 ,3 ]
Harper, Marvin [1 ,3 ]
机构
[1] Boston Childrens Hosp, Div Emergency Med, Dept Med, Boston, MA 02115 USA
[2] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Div Crit Care, Boston, MA 02115 USA
[3] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA
[4] Harvard Med Sch, Dept Anesthesiol, Boston, MA 02115 USA
来源
JOURNAL OF PEDIATRICS | 2021年 / 235卷
关键词
ORGAN DYSFUNCTION; SEPTIC SHOCK; MORTALITY; ANTIBIOTICS; PREVALENCE; GUIDELINES; CHILDREN; LENGTH; ALERT; TIME;
D O I
10.1016/j.jpeds.2021.03.053
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To determine the effect of an automated sepsis screening tool on treatment and outcomes of severe sepsis in a pediatric emergency department (ED). Study design Retrospective cohort study of encounters of patients with severe sepsis in a pediatric ED with a high volume of pediatric sepsis cases over a 2-year period. The automated sepsis screening algorithm replaced a manual screen 1 year into the study. The primary outcome was the proportion of patients treated for sepsis while in the ED. Secondary outcomes were time from ED arrival to first intravenous (IV) antibiotic and first IV fluid bolus, volume of fluid administered in the ED, 30-day mortality, intensive care unit-free days, and hospital-free days. Results In year 1 of the study, 8910 of 61 026 (14.6%) of encounters had a manual sepsis screen; 137 patients met criteria for severe sepsis. In year 2, 100% of 61 195 encounters had an automated sepsis screen and there were 136 cases of severe sepsis. There was a higher proportion of patients with severe sepsis who had an active malignancy and indwelling central venous catheter in year 2. There were no differences in the proportion of patients treated for sepsis in the ED, time to first IV antibiotic or first IV fluid bolus, fluid volume delivered in the ED, hospital-free days, intensive care unit-free days, or 30-day mortality after implementation of the automated screening algorithm. Conclusions An automated sepsis screening algorithm introduced into an academic pediatric ED with a high volume of sepsis cases did not lead to improvements in treatment or outcomes of severe sepsis in this study.
引用
收藏
页码:239 / +
页数:11
相关论文
共 50 条
  • [1] IMPACT OF THE EMERGENCY DEPARTMENT SEPSIS SCREENING TOOL ON OUTCOMES IN PATIENTS WITH SEPSIS
    Shah, Tanvi
    Rech, Megan
    Sterk, Ethan
    [J]. CRITICAL CARE MEDICINE, 2016, 44 (12)
  • [2] Comparison of Manual and Automated Sepsis Screening Tools in a Pediatric Emergency Department
    Eisenberg, Matthew
    Freiman, Eli
    Capraro, Andrew
    Madden, Kate
    Monuteaux, Michael C.
    Hudgins, Joel
    Harper, Marvin
    [J]. PEDIATRICS, 2021, 147 (02)
  • [3] Automated emergency department sepsis screening appears superior to manual screening
    Scott, Halden F.
    Bennett, Tellen D.
    [J]. JOURNAL OF PEDIATRICS, 2021, 234 : 287 - 287
  • [4] Performance of an Automated Severe Sepsis Screening Tool in the Emergency Department
    Santistevan, J. R.
    Hamedani, A.
    Werner, E.
    Spranger, J.
    Sharp, B.
    [J]. ANNALS OF EMERGENCY MEDICINE, 2017, 70 (04) : S163 - S164
  • [5] Automating a Manual Sepsis Screening Tool in a Pediatric Emergency Department
    Lloyd, Julia K.
    Ahrens, Erin A.
    Clark, Donnie
    Dachenhaus, Terri
    Nuss, Kathryn E.
    [J]. APPLIED CLINICAL INFORMATICS, 2018, 9 (04): : 803 - 808
  • [6] Emergency department sepsis screening tool decreases time to antibiotics in patients with sepsis
    Shah, Tanvi
    Sterk, Ethan
    Rech, Megan A.
    [J]. AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2018, 36 (10): : 1745 - 1748
  • [7] Application of the Improving Pediatric Sepsis Outcomes Definition for Pediatric Sepsis to Nationally Representative Emergency Department Data
    Ramgopal, Sriram
    Adler, Mark D.
    Horvat, Christopher M.
    [J]. PEDIATRIC QUALITY & SAFETY, 2021, 6 (05) : E468
  • [8] Independent Validation of Sepsis Index for Sepsis Screening in the Emergency Department
    Agnello, Luisa
    Iacona, Alessandro
    Maestri, Salvatore
    Lo Sasso, Bruna
    Giglio, Rosaria Vincenza
    Mancuso, Silvia
    Ciaccio, Anna Maria
    Vidali, Matteo
    Ciaccio, Marcello
    [J]. DIAGNOSTICS, 2021, 11 (07)
  • [9] An estimate of missed pediatric sepsis in the emergency department
    Cifra, Christina L.
    Westlund, Erik
    Ten Eyck, Patrick
    Ward, Marcia M.
    Mohr, Nicholas M.
    Katz, David A.
    [J]. DIAGNOSIS, 2021, 8 (02) : 193 - 198
  • [10] A new tool for sepsis screening in the Emergency Department
    Agnello, Luisa
    Iacona, Alessandro
    Lo Sasso, Bruna
    Scazzone, Concetta
    Pantuso, Michele
    Giglio, Rosaria Vincenza
    Gambino, Caterina Maria
    Ciaccio, Anna Maria
    Bivona, Giulia
    Vidali, Matteo
    Ciaccio, Marcello
    [J]. CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2021, 59 (09) : 1600 - 1605