[Sepsis in Emergency Medicine]

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Emergency Medicine

Background:

• Sepsis, characterized by life-threatening organ dysfunction from infection, has high mortality, often exceeding 10% in hospitalized patients.
• Current sepsis management standards in intensive care units have not substantially reduced mortality.
• A significant proportion of sepsis patients (around 80%) are transferred to ICUs from general wards or emergency departments, suggesting potential for earlier intervention.

Purpose of the Study:

• To investigate the potential for improving sepsis management outside of intensive care units.
• To evaluate the effectiveness of early identification and standardized treatment protocols in reducing sepsis-related mortality.

Main Methods:

• Utilized the quick sequential organ failure assessment (qSOFA) score, comprising respiratory rate, systolic blood pressure, and altered mental status, to identify at-risk patients.
• Implemented subsequent treatment according to current sepsis management guidelines for patients identified with suspected infection and increased mortality risk.

Main Results:

• A substantial decrease in in-hospital mortality, approximately 20%, was observed in patients with community-acquired pneumonia presenting to the emergency department.
• The qSOFA score effectively identified patients with infection and increased risk of in-hospital death.

Conclusions:

• Sepsis patient management decisions should be initiated outside ICUs upon initial presentation to healthcare providers.
• Structured and standardized sepsis management protocols in acute care settings are crucial for improving survival rates, even in cases of mild organ dysfunction.