FACTORS ASSOCIATED WITH THE EARLY IDENTIFICATION OF SEPSIS

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Carolyn C. Brown (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: The incidence of sepsis is increasing and is one of the most frequent causes of death in hospitals in the United States. Sepsis is a heterogeneous clinical syndrome that is difficult to identify in rapid clinical settings such as the emergency department (ED). The purpose of this study was to identify a model that will inform the development of a sepsis screening tool for early recognition of sepsis on arrival to the ED. A retrospective chart review , study sample was obtained from an administrative database. Study data were collected , and prepared , and descriptive and comparison analytics performed. Logistic regression was used for model building. Odds ratios were used to build a scoring tool which was tested for sensitivity and specificity. Most of the sample was White (76.5%) , female (51.7%) , and lived at home (81.3%). The mean age of sepsis was 64.95 years (SD = 18.73) and the mean age for severe sepsis/septic shock 68.3 years (SD = 14.32). Only 6.7% of individuals with sepsis died , and 25% of individuals with severe sepsis/septic shock died during their hospital stay. Variables were entered into the model in a stepwise process. The final model consisted of five variables: (a) systolic blood pressure [less-than or equal to] 100 mmHg (yes/no) , (b) ages [greater-than or equal to] 54 or [less-than or equal to] 80 years (yes/no) , (c) respiratory rate [greater-than or equal to] 22 breaths per minute (yes/no) , (d) chief complaint of fever or chills (yes/no) , and (e) altered mental status or Glasgow Coma Scale [less-than or equal to] 14 (yes/no). The model was statistically significant ( -2 Log Likelihood = 759.80 , [chi]2(5) = 71.98 , p <.000). A scoring tool was build and each individual in the initial study was scored using the scoring tool. A score [greater-than or equal to] 4 had a sensitivity level 68% , a specificity of 55% , and area under the receiver operating curve of 0.65. The new sepsis tool requires further investigation to improve sensitivity and specificity.

Additional Information

Publication

Dissertation

Language: English

Date: 2017

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