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Prehospital characteristics among patientswith sepsis: a comparison between patients with or without adverse outcome
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (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. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden. (PreHospen)ORCID iD: 0000-0001-7865-3480
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2019 (English)In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, article id 19:43Article in journal (Refereed) Published
Abstract [en]

Background: The prehospital care of patients with sepsis are commonly performed by the emergency medical services. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients with sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse prognosis. Therefore, early identification of patients with sepsis is important, and more information about the prehospital characteristics that can be used to identify these patients is needed. Based on this lack of information, the objectives of this study were to investigate the prehospital characteristics that are identified while patients withseps is are being transported to the hospital by the emergency medical services, and to compare these values to those of the patients with and without adverse outcomes during their hospital stays.

Methods: This was a retrospective observational study. The patients’ electronic health records were reviewed and selected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an emergency department by the emergency medical services. Data were collected on demographics, prehospital characteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit, and analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital characteristics for predicting or development of adverse outcome were analysed.

Results: In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing patients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serumglucose level and altered mental status during prehospital care were found to be associated with an adverse outcome.

Conclusions: The findings suggests that patients having a decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient prognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with sepsis early and improve their long-term outcomes. However further research is required to predict limit values of saturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients with sepsis.

Place, publisher, year, edition, pages
2019. article id 19:43
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Infectious Medicine
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Människan i vården
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URN: urn:nbn:se:hb:diva-21573DOI: 10.1186/s12873-019-0255-0OAI: oai:DiVA.org:hb-21573DiVA, id: diva2:1341066
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-08-07Bibliographically approved

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Olander, AgnesAndersson, HenrikSundler, Annelie JohanssonBremer, AndersAndersson Hagiwara, Magnus

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