The Predictive Clinical Parameter for Diagnosing Sepsis and Predicting Death in Emergency Department Saraburi Hospital
Keywords:
Sepsis, Vital signs, Screening, MortalityAbstract
Introduction : Sepsis is a crucial cause of death worldwide. Early diagnosis and treatment can reduce the mortality rate. The vital signs measurement may be used as a quick and convenient screening tool for an early diagnosis of sepsis.
Objectives : This study was aimed to evaluate the correlation between triage of clinical parameters including vital signs and other possible factors and diagnosis of sepsis-related and mortality.
Method : This exploratory retrospective cohort included patients visiting the Emergency Department at Saraburi hospital during January 2019. The patients were categorized into 2 subgroups: (1) diagnosed with sepsis and (2) diagnosed otherwise. These two subgroups will proceed for further analysis including the correlation between the incidence of sepsis and baseline characteristics, triage vital signs, underlying diseases, and confounding factors with the diagnosis of sepsis and sepsis-related mortality.
Results : This study enrolled a total of 500 patients, who were classified into sepsis (n = 82) and non-sepsis (n = 418) groups. The study found that the age [Adjust risk ratio (aRR): 1.02, 95% CI: 1.01-1.04], heart rate [aRR: 1.01, 95% CI: 1.01-1.02], body temperature [aRR: 1.35, 95% CI: 1.12-1.63], oxygen saturation [aRR: 0.96, 95% CI: 0.93-0.99], immunocompromised host [aRR: 4.79, 95% CI: 1.80-12.77] and cerebrovascular disease [aRR: 1.82, 95% CI: 1.01- 3.27] were significantly correlated to sepsis risk, whereas hypertension [aRR: 0.55, 95% CI: 0.31-0.97] showed significant reverse correlation. However, only respiratory rate has shown significant correlation with the mortality rate in the sepsis subgroup. [aRR: 1.06, 95% CI: 1.01-1.13]
Conclusion : Age, heart rate, body temperature, oxygen saturation, immunocompromised host and cerebrovascular disease are strong predictors for the diagnosis of sepsis and respiratory rate is the only parameter that associated with sepsis-related mortality rate among those diagnosed with sepsis.
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