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The Effect of Early Warning Systems for Sepsis on Mortality: A Systematic Review and Meta-analysis
Samer Ein Alshaeba1,2, Elizabeth A Marhoffer3,4, Jürgen L Holleck3,4
1Department of Medicine, Yale School of Medicine, New Haven, CT, USA. samer.einalshaeba@yale.edu.
Journal of General Internal Medicine
|May 13, 2025
Summary
Current evidence does not support sepsis screening. More research is needed to determine if sepsis screening improves patient outcomes like mortality or antibiotic timing.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Health Services Research
Background:
- The Surviving Sepsis Campaign recommends hospital sepsis screening.
- The impact of sepsis screening on patient outcomes remains unclear.
Purpose of the Study:
- To systematically evaluate the effectiveness of sepsis screening systems.
- To assess the impact of sepsis screening on mortality, antibiotic administration, and hospital length of stay.
Main Methods:
- Systematic literature search of randomized controlled trials (RCTs) up to June 1, 2024.
- Meta-analysis of 7 RCTs involving 3409 patients.
- Assessed risk of bias and strength of evidence using GRADE and Cochrane tools.
Main Results:
- Sepsis screening did not significantly reduce mortality (OR 0.84, 95% CI 0.60-1.18).
- No significant differences in time to antibiotics or length of stay were observed.
- Overall strength of evidence was low due to bias and imprecision.
Conclusions:
- Insufficient evidence exists from RCTs to recommend sepsis screening.
- Current guidelines for sepsis screening may need revision based on this evidence.
