Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • harvard-cite-them-right
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)ORCID iD: 0000-0003-3624-1087
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0002-9194-3244
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Linnaeus University, Faculty of Health and Life Sciences, Växjö, Sweden.ORCID iD: 0000-0001-7865-3480
Show others and affiliations
2023 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 38, no 2, p. 160-167Article in journal (Refereed) Published
Abstract [en]

Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. 

Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. 

Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. 

Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. 

Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.

Place, publisher, year, edition, pages
2023. Vol. 38, no 2, p. 160-167
Keywords [en]
ambulance clinician, ambulance service, glucose, lactate, sepsis
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-29443DOI: 10.1017/s1049023x23000110ISI: 000929336400001Scopus ID: 2-s2.0-85150666227OAI: oai:DiVA.org:hb-29443DiVA, id: diva2:1736365
Available from: 2023-02-13 Created: 2023-02-13 Last updated: 2024-02-01Bibliographically approved

Open Access in DiVA

fulltext(574 kB)67 downloads
File information
File name FULLTEXT01.pdfFile size 574 kBChecksum SHA-512
a005a35651976f16a71893f5401b0b5f51c2f6cd3102808537a4aed0312c8756fd569321186d03eb8e7a4b7d1436219cb2fae52baabec50e732be6936f719799
Type fulltextMimetype application/pdf

Other links

Publisher's full textScopus

Authority records

Olander, AgnesSundler, Annelie JohanssonBremer, AndersAndersson, HenrikHerlitz, JohanAxelsson, ChristerAndersson Hagiwara, Magnus

Search in DiVA

By author/editor
Olander, AgnesSundler, Annelie JohanssonBremer, AndersAndersson, HenrikHerlitz, JohanAxelsson, ChristerAndersson Hagiwara, Magnus
By organisation
Faculty of Caring Science, Work Life and Social Welfare
In the same journal
Prehospital and Disaster Medicine
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 67 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 52 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • harvard-cite-them-right
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf