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Presenting Symptoms in Sepsis: Is the Mnemonic "SEPSIS" Useful?
Kanokpit Wattanapaiboon1, Sarach Banditlerdruk1, Veerapong Vattanavanit2
1Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Infection and Drug Resistance
|August 6, 2020
Summary
The "SEPSIS" mnemonic may miss critical sepsis symptoms, particularly in patients with immunosuppression or intra-abdominal infections. Revision is needed to improve sepsis diagnosis and patient outcomes.
Area of Science:
- Emergency Medicine
- Critical Care Medicine
- Infectious Diseases
Background:
- The "SEPSIS" mnemonic was developed to increase public awareness of sepsis symptoms.
- Validation of the "SEPSIS" mnemonic in clinical practice is lacking.
Purpose of the Study:
- To evaluate the validity of the "SEPSIS" mnemonic in identifying sepsis and septic shock patients.
- To assess the association between mnemonic symptoms and in-hospital mortality.
Main Methods:
- Retrospective, observational, single-center study of adult patients with sepsis or septic shock.
- Data collected from emergency department presentations between 2016 and 2019.
- Analysis of symptom presentation based on the "SEPSIS" mnemonic and correlation with patient outcomes.
Main Results:
- Of 437 patients, 14.9% lacked "SEPSIS" mnemonic symptoms. Patients without mnemonic symptoms were more likely to have immunosuppression (24.6%) and intra-abdominal infections (38.5%).
- Rarely reported symptoms included "feels like you are going to die" (1.1%) and "skin mottled or discolored" (1.1%).
- Vague-presenting symptoms, not aligning with the mnemonic, were independently associated with higher in-hospital mortality (aOR 2.17).
Conclusions:
- The "SEPSIS" mnemonic has limited clinical utility due to low reporting of certain symptoms.
- Relying solely on the mnemonic may lead to missed diagnoses, especially in vulnerable populations.
- The mnemonic requires revision to better reflect sepsis presentation and improve diagnostic accuracy.
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