ArticleBMC emergency medicine2017
Sepsis recognition in the emergency department - impact on quality of care and outcome?
Article in BMC emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Evaluating Artificial Intelligence for Sepsis Prediction in Emergency Departments: A Systematic Review and Meta Analysis.Journal of medical systems · 2026Pooled it
- Early fluid bolus in adults with sepsis in the emergency department: a systematic review, meta-analysis and narrative synthesis.BMC emergency medicine · 2022Pooled it
- Co-Evaluation of Lactate, Base Excess, and Albumin as Predictors of Mortality in Sepsis by Excluding the Factors That Affect Their Levels: An Observational Study.Biomedicines · 2025Article
- Cell population data for early detection of sepsis in patients with suspected infection in the emergency department.Clinical chemistry and laboratory medicine · 2025Article
- Diagnosis of sepsis in the emergency department: a real-world analysis from Lombardy, Italy.Internal and emergency medicine · 2024Article
- Exploiting the Features of Clinical Judgment to Improve Assessment of Disease Severity in the Emergency Department: An Acutelines Study.Journal of clinical medicine · 2024Article
- Analysis of Variation Between Diagnosis at Admission vs Discharge and Clinical Outcomes Among Adults With Possible Bacteremia.JAMA network open · 2022Article
- Monocyte distribution width as part of a broad pragmatic sepsis screen in the emergency department.Journal of the American College of Emergency Physicians open · 2022Article
- Combined hydrocortisone, ascorbic acid, and thiamine therapy for septic shock with complicated intraabdominal infection: before and after cohort study.Annals of surgical treatment and research · 2021Article
- Assessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency Department.Critical care explorations · 2021Article
- Sepsis in surgical inpatients: under-recognised but with significant consequences.Irish journal of medical science · 2021Article
- Deep Learning for Identification of Acute Illness and Facial Cues of Illness.Frontiers in medicine · 2021Article
- The Available Criteria for Different Sepsis Scoring Systems in the Emergency Department-A Retrospective Assessment.Open access emergency medicine : OAEM · 2021Article
- Article
- Early diagnosis of sepsis in emergency departments, time to treatment, and association with mortality: An observational study.PloS one · 2020Observational
- Monocyte distribution width enhances early sepsis detection in the emergency department beyond SIRS and qSOFA.Journal of intensive care · 2020Article
- Biomarkers and clinical scores to identify patient populations at risk of delayed antibiotic administration or intensive care admission.Critical care (London, England) · 2019Article
- Predictors of 30-Day In-Hospital Mortality in Patients Undergoing Urgent Abdominal Surgery Due to Acute Peritonitis Complicated with Sepsis.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
- Current Issues and Perspectives in Patients with Possible Sepsis at Emergency Departments.Antibiotics (Basel, Switzerland) · 2019Review
- Targeting the Blood-Brain Barrier to Prevent Sepsis-Associated Cognitive Impairment.Journal of central nervous system disease · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAppropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED).
methodsThis study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians. The study team independently rated quality of sepsis classification (American College of Chest Physicians/Society of Critical Care Medicine definitions), diagnostic workup, and guideline-adherent therapy in the ED.
resultsOf 487 included patients, 110 presented because of infection. Of those, 54 patients matched sepsis criteria, including 20 with organ damage and thus severe sepsis, as rated by the study team. Sepsis was not recognized in 32 of these 54 cases (59%). Multivariate binary logistic regression analysis revealed that higher systolic blood pressure (p <0.05), the ability to stand (p <0.01) and a low number of documented vital signs in the ED discharge letter (p < 0.05) were independent predictors of missed sepsis. Surprisingly, adequate detection of the septic focus (81 vs. 93%, p = 0.17), appropriate fluid administration (86 vs. 87%, p = 0.39), and guideline-adherent antibiotic regimen (95 vs. 100%, p = 0.42) did not differ between cases of recognized and unrecognized sepsis, respectively. Non-recognition affected neither death-censored length of hospital stay (median 7.63 d vs. 7.13 d, p = 0.42) nor a combined endpoint of death or ICU admission to (9 vs. 12%, p = 0.55).
conclusionsNon-recognition of sepsis in ED patients with serious infections who formally meet organizational sepsis definitions seems to have no deleterious impact on initial therapy adequacy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.