Clinical and Demographic Parameters of Patients Treated Using a Sepsis Protocol
The purpose of this study was to investigate potential differences by sex in the demographic and clinical characteristics of patients treated utilizing a sepsis electronic bundle order set. Risk factors for in-hospital mortality were also assessed.
Data on patients in whom the sepsis order set was initiated in the emergency department over a 16-month period were entered into the hospital database. Data were analyzed for differences by sex in demographic and clinical factors, treatment modalities, and in-hospital mortality. The Bonferroni correction was applied to account for multiple comparisons; α was set at 0.006 for sex differences.
A total of 2204 patients were included. Male and female cohorts were similar with regard to a variety of demographic and clinical factors, including age, Emergency Severity Index (ESI) levels 1 and 2, time to disposition, appropriateness of antibiotics, and total fluids given by weight. The ESI is an assessment score ranging from 1 to 5 (1 is emergent). There were modest differences in the source of infection (genitourinary was 4% more common in women; P = 0.03) and mode of arrival (men were 4% more likely to arrive by ambulance; P = 0.03). These differences did not achieve our predefined α of 0.006 when the Bonferroni correction was applied. Factors associated with in-hospital mortality were advanced age, arrival by ambulance, and an ESI level of 1 or 2 (all, P < 0.01).
Women were more likely to have a genitourinary cause of sepsis and less likely to arrive by ambulance. Risk factors of in-hospital mortality were older age, arrival by ambulance, and an ESI level of 1 or 2, but not sex.
Published In/Presented At
Ward, H. H., Kiernan, E. A., Deschler, C. Murillo, S. M., Karoly, S. Macfarlan, J. E., McCambridge, M. M., Richardson, D. M., MacKenzie, R. S., Greenberg, R. M., Jacoby, J. L. (2019, May). Clinical and Demographic Parameters of Patients Treated Using a Sepsis Protocol. Clinical Therapeutics, 41(6), 1020-1028. https://doi.org/10.1016/j.clinthera.2019.03.016
Emergency Medicine | Internal Medicine
Department of Emergency Medicine, Department of Emergency Medicine Faculty, Department of Emergency Medicine Residents, Network Office of Research and Innovation