Sepsis: definitions, prevalence, management and outcomes

[摘要] Introduction:Sepsis results in life-threatening organ dysfunction, but if recognised and treated promptly, survival chances increase.Current clinical practice uses the systemic inflammatory response syndrome criteria to identify sepsis, and the sepsis six care bundle for management.Changes to the definitions of sepsis internationally and new national sepsis guidelines call into question the most appropriate way to recognise and manage sepsis.Method:This was a two-site audit of healthcare provider’s compliance to the sepsis six care bundle.All patients admitted to two NHS hospitals over 24 hours were screened for sepsis using the modified systemic inflammatory response syndrome criteria and the quick-sequential (sepsis related) organ failure assessment score.Adherence was assessed for each element of the care bundle for all patients identified with sepsis. Results:249 patients were screened for sepsis; 24 fulfilled the modified systemic inflammatory response syndrome criteria for sepsis, and six fulfilled quick-sequential (sepsis related) organ failure assessment criteria.Compliance was poor; only one patient received all elements of the sepsis six care bundle.Three patients (12%) died within 60 days of admission; all three were receiving palliative cancer care. Conclusion:Current management of sepsis is below recommended standards.The prevalence of sepsis is different depending upon the screening method used.Recommendations for future work include validation of the new sepsis definitions for mortality and morbidity rates.

[发布机构] University:University of Birmingham;Department:Institute of Inflammation and Ageing

[关键词] R Medicine;R Medicine (General)