Performance Characteristics of Sepsis Screening Tools During Delivery Admissions.

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease
• Critical Care Medicine

Background:

• Sepsis is a life-threatening condition that can occur during delivery admissions.
• Accurate and timely diagnosis of sepsis is crucial for effective treatment and improved patient outcomes.
• Existing sepsis screening tools require evaluation for their performance in the obstetric population.

Purpose of the Study:

• To evaluate the screening performance characteristics of existing tools for the diagnosis of sepsis during delivery admissions.
• To compare the sensitivity and false-positive rates of multiple sepsis screening criteria.

Main Methods:

• A case-control study utilizing electronic health record data from 59 hospitals.
• Patients with sepsis during delivery admissions were matched with controls.
• Evaluated screening criteria included CMQCC, SIRS, MEWC, UKOSS, and MEWT.
• Analyses were stratified into cohorts with and without chorioamnionitis-endometritis.

Main Results:

• In the absence of chorioamnionitis-endometritis, CMQCC and UKOSS demonstrated the lowest false-positive rates (6.9% and 9.6%) and highest C-statistics (0.92 and 0.91).
• SIRS and MEWC showed similar sensitivities but significantly higher false-positive rates.
• In the presence of chorioamnionitis-endometritis, CMQCC and UKOSS still yielded the highest C-statistics (0.67 and 0.64).

Conclusions:

• CMQCC and UKOSS pregnancy-adjusted criteria are effective for sepsis screening during delivery admissions, offering low false-positive rates and high sensitivity.
• The performance of all evaluated sepsis screening tools is diminished in the presence of chorioamnionitis-endometritis.