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SCCM 2014: Screening for Sepsis in the ED

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The Particulars: National data indicate that sepsis accounts for more than 1 million cases, nearly 200,000 deaths, and $16.4 billion in healthcare costs annually in the United States. However, early identification of sepsis remains difficult because of its ambiguous manifestation.

Data Breakdown: For a study, a sepsis screening tool was developed that measured tissue oxygen saturation (StO2), heart rate, respiration rate, and temperature at triage. The tool had a sensitivity of 85.7%, a specificity of 78.4%, a positive predictive value of 26.7%, and a negative predictive value of 98.4% for detecting sepsis. Abnormal StO2 values increased with the severity of sepsis, from non-septic (37.1%) to septic shock (80.0%).

Take Home Pearls: Heart rate, respiration rate, and temperature appear to have good diagnostic potential for early identification of sepsis in ED patients at triage. StO2 may also play a role in identifying sepsis early, but further investigation of StO2 in this population requires further research.

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