Sepsis Care Improved in the ED

Sepsis is a life-threatening condition that requires immediate medical attention. The condition occurs when the body’s overwhelming immune response to infection triggers widespread inflammation that drops blood pressure and may lead to shock. Each year, about 750,000 people in the United States get sepsis, and it’s increasingly affecting the elderly population. When patients receive appropriate care in a timely fashion, the death rate associated with sepsis decreases substantially. However, if these patients go into shock, as many as 50% will die from it. Patients can present with sepsis in many ways and are either admitted through the ED or directly admitted to the hospital. While early aggressive resuscitation in patients with severe sepsis can decrease mortality, this requires extensive time and resources (see also, Procalcitonin: A Biomarker for Early Sepsis Intervention). In the February 2011 American Journal of Emergency Medicine, Emilie Powell, MD, MBA, my colleagues, and I had a study published in which we analyzed if patients with sepsis admitted through the ED have lower inpatient mortality than those admitted directly to the hospital . Comparing Inpatient Mortality for Sepsis In our analysis, we analyzed 2008 data from the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample from the AHRQ. The cross-sectional analysis examined hospitalizations with a principal diagnosis of sepsis in institutions with an annual minimum of 25 ED and 25 direct admissions for sepsis. The study controlled for patient and hospital characteristics. We also assessed the likelihood of early inpatient mortality—defined as within 2 days of the admission—and overall inpatient mortality. Nearly 100,000 hospitalizations with a principal diagnosis of sepsis were examined from 290 hospitals. Because...