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Identification of sepsis in paediatric emergency departments: A scoping review
Sivakumar Oruganti1,2, Jordan Evans3, Thomas Cromarty3
1Noah's Ark Children's Hospital for Wales, Cardiff, UK.
Insights
This review explored methods for identifying pediatric sepsis in emergency departments. It found varied approaches but a recent research focus on patient outcomes for better sepsis detection tools.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Informatics
- Public Health
Background:
- Sepsis is a life-threatening condition requiring prompt identification and management.
- Early sepsis detection in children presenting to emergency departments is crucial for improving outcomes.
- Significant morbidity and mortality are associated with sepsis.
Purpose of the Study:
- To conduct a scoping review of methods used for identifying sepsis in pediatric emergency department populations.
- To explore the heterogeneity and evolution of sepsis identification strategies in children.
- To identify research trends and future directions in pediatric sepsis detection.
Main Methods:
- A systematic literature search was performed in Medline and Web of Science databases.
- Studies published between 1990 and 2022 were included.
- Data extracted included age groups, study design, reference standards, and sepsis identification methods.
Main Results:
- Eighty-nine studies were identified.
- Significant heterogeneity was observed in study designs, age groups, and reference standards used.
- A notable increase in published research on pediatric sepsis identification methods has occurred in the last two years.
Conclusions:
- The review highlights marked heterogeneity in sepsis identification approaches for children.
- There is a recent and growing research focus on patient outcomes in pediatric sepsis.
- Standardized core outcome sets, robust reference standards, and continuous monitoring are needed to validate effective sepsis identification tools and assess their impact on patient outcomes.
Aim:
Sepsis is an acute illness associated with significant morbidity and mortality. Early detection and time-sensitive management of sepsis has been shown to improve outcomes. We report the results of a scoping review to explore methods evaluated for the identification of sepsis in children presenting to emergency departments.
Methods:
A systematic literature search was carried out on two databases, Medline and Web of Science, to identify relevant studies published from 1990 to 2022. Data were extracted for age groups including study design, reference standard used for comparison, sepsis identification method evaluated and study quality.
Results:
A total of 89 studies were identified from the literature search. There was significant heterogeneity in the age groups including study design and reference standards used for evaluating the performance of the sepsis identification methods. There has been a substantial increase in the number of published studies in the last 2 years.
Conclusion:
Our scoping review identifies marked heterogeneity in approaches to identifying sepsis but demonstrates a recent focus of research on patient outcomes. Using appropriate core outcome sets, developing reference standards, monitoring sepsis prevalence via registries and continuously monitoring process measures will provide robust evidence to identify the best performing identification tools and the impact they have on patient-orientated outcomes.
