PROFILING OF SEPSIS PATIENTS IN THE EMERGENCY DEPARTMENT - A RETROSPECTIVE STUDY

Sepsis and septic shock are major healthcare problems, impacting millions of people around the world each year killing between one in three and one in six of those it affects[1].Infection-prevention efforts, including those targeting both community-acquired and health-care-associated infections, can reduce sepsis incidence. It is treatable, and timely implementation of targeted interventions improves outcomes.There are various scoring system like Sequential Organ Failure Assessment (SOFA), Modified Early Warning Score(MEWS), Rapid Emergency Medicine Score, APACHE II in early identification of sepsis. But in a resource limited setting, there is a need of early identification and initiation of treatment. Hence there is a need for clinical bedside scoring system to identify patients at risk for improving the outcomes as early administration of appropriate antimicrobials is one of the most effective interventions to reduce mortality in patients with sepsis.This retrospective study involved total of 305 patients who were admitted to Multidisciplinary ICU or High Dependence Unit from Emergency room for a period of 6 months. Of which 105 patients were suspected to have sepsis or identified in shock. The most common comorbid medical condition was found to be diabetes mellitus and respiratory symptoms accounted for majority of the cases.Timing of antibiotic in patients with suspected sepsis and patients with septic shock mean time of which was found to be 61 minutes and 53 minutes respectively which is compliant with the current recommendations.脓毒症（Sepsis）与脓毒性休克（Septic Shock）是重大医疗卫生难题，每年影响全球数百万人群，患者病死率介于1/6至1/3之间[1]。包括针对社区获得性感染与医疗相关感染的感染防控措施，可降低脓毒症的发病率。脓毒症具备可治疗性，及时实施针对性干预措施可改善患者预后。目前已有多种评分系统用于脓毒症的早期识别，例如序贯器官衰竭评分（Sequential Organ Failure Assessment, SOFA）、修正早期预警评分（Modified Early Warning Score, MEWS）、快速急诊医学评分以及急性生理学与慢性健康状况评分系统Ⅱ（APACHE II）。但在资源有限的医疗环境中，仍需实现脓毒症的早期识别与治疗启动。因此，亟需开发临床床边评分系统以识别高危患者、改善预后——因为尽早给予恰当的抗菌药物治疗，是降低脓毒症患者病死率的最有效干预手段之一。本项回顾性研究共纳入305名患者，这些患者于6个月内从急诊室转入多学科重症监护室（Multidisciplinary ICU）或高依赖病房（High Dependence Unit）。其中105名患者被怀疑罹患脓毒症或已确诊为脓毒性休克。最常见的合并基础疾病为糖尿病，且呼吸系统症状在病例中占比最高。疑似脓毒症患者与脓毒性休克患者的抗菌药物给药平均时间分别为61分钟与53分钟，这一结果符合当前临床推荐标准。