New Screening strategies to identify sepsis in the prehospital setting provided by Advance life support unit
Keywords:
sepsis, infection, emergency medical serviceAbstract
Background: Sepsis is one of the leading causes of death and disability in Thailand. Sepsis is a difficult condition to diagnose. There are many types of diagnostic tools available today. Each tool has difficulty to use and have different sensitivity and specificity for screening out-of-hospital sepsis. But none of them was recognized as the best tool.
Objective: To study the relationship between factors and the diagnosis of out-of-hospital sepsis delivered by advance life support unit and to take the factors that affect the diagnosis to create a new approach for screening patients with out-of-hospital sepsis.
Method: A Retrospective cohort study was conducted from January 1, 2020 to January 31, 2021 in patients suspected sepsis compared with final diagnosis. The data were collected from medical records during transport and digital medical records. Then, using the data to analyze the relationship of factors affecting the diagnosis sepsis.
Results: Of 285 patients, 129 patients were found to have sepsis. Risk factors of out of hospital sepsis with statistical significance are systolic blood pressure≤ 90 mmHg (OR 4.397, 95%CI 2.106-90178, p<0.001), Pulse oximetry≤ 94% (OR 2.652, 95%CI 1.551-4.445, p<0.001),Blood glucose>180mg/dL (OR 3.812, 95%CI 1.677-8.663, p=0.001) and Glasgow Coma Scale≤14 (OR 1.866, 95%CI 1.103-3.159, p=0.020).
Conclusion: Factors affecting the diagnosis of patients with out-of-hospital sepsis transport by advance life support unit are systolic blood pressure≤ 90 mmHg, Pulse oximetry≤ 94%, Blood glucose>180mg/dL and Glasgow Coma Scale≤14 .
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บทความที่ได้รับตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย ถือเป็นเป็นลิขสิทธิ์ของ วิทยาลัยแพทย์เวชศาสตร์ฉุกเฉินแห่งประเทศไทย
กรณีที่บทความได้รับการตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทยแล้ว จะตีพิมพ์ในรูปแบบอิเล็กทรอนิกส์ ไม่มีสำเนาการพิมพ์ภายหลังหนังสือเผยแพร่เรียบร้อยแล้ว ผู้นิพนธ์ไม่สามารถนำบทความดังกล่าวไปนำเสนอหรือตีพิมพ์ในรูปแบบใดๆ ที่อื่นได้ หากมิได้รับคำอนุญาตจากวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย
