Identifying Patients With Sepsis on the Hospital Wards

Chest. 2017 Apr;151(4):898-907. doi: 10.1016/j.chest.2016.06.020. Epub 2016 Jul 1.

Abstract

Sepsis contributes to up to half of all deaths in hospitalized patients, and early interventions, such as appropriate antibiotics, have been shown to improve outcomes. Most research has focused on early identification and treatment of patients with sepsis in the ED and the ICU; however, many patients acquire sepsis on the general wards. The goal of this review is to discuss recent advances in the detection of sepsis in patients on the hospital wards. We discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening patients with sepsis, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick sepsis-related organ failure assessment (qSOFA) score. Challenges specific to detecting sepsis on the wards are discussed, and future directions that use big data approaches and automated alert systems are highlighted.

Keywords: SIRS; SOFA; clinical decision support systems; sepsis.

Publication types

  • Review
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Decision Support Systems, Clinical*
  • Diagnosis, Differential
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Organ Dysfunction Scores
  • Sepsis / diagnosis*
  • Sepsis / mortality
  • Systemic Inflammatory Response Syndrome / diagnosis
  • Systemic Inflammatory Response Syndrome / mortality