Primary Infection Site as a Predictor of Sepsis Development in Emergency Department Patients

Area of Science:

• Emergency Medicine
• Infectious Diseases
• Critical Care Medicine

Background:

• Sepsis poses a significant threat, yet predicting its onset and progression remains difficult.
• Identifying risk factors is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To investigate the influence of the primary infection site on sepsis development in emergency department (ED) patients.
• To assess the association between infection source and clinical outcomes, including mortality.

Main Methods:

• Retrospective analysis of ED patient data from January 2016 to December 2019.
• Inclusion of patients with documented upper respiratory tract (URI), lower respiratory tract (LRI), urinary tract (UTI), or skin/soft-tissue infections.
• Statistical analysis using logistic regression to compare outcomes based on infection site, with URI as the reference.

Main Results:

• Lower respiratory tract infections (LRIs) showed the highest association with sepsis (RRR 5.63) and septic shock (RRR 21.2).
• LRIs were also linked to increased hospital admission (OR 8.23), ICU admission (OR 4.27), in-hospital mortality (OR 6.93), and 30-day mortality (OR 7.34).
• Urinary tract infections (UTIs) were associated with sepsis and septic shock, though to a lesser extent than LRIs.

Conclusions:

• The site of primary infection significantly impacts sepsis development and patient outcomes.
• LRIs and UTIs are key infection sources associated with increased risk of sepsis, hospitalization, prolonged length of stay, and mortality.
• Understanding infection site-specific risks can inform ED sepsis management strategies.