Point of care methods to differentiate sepsis from similar groups of symptoms in the emergency department
Molnár Gyula
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
Egészségtudományi Kar, Vas utca 17. fsz. 30. terem
2024-10-18 11:00:00
Physiology and Pathophysiology of the Regulation of Fluids and Electrolyte Homeostasis
Dr. Zsembery Ákos
Dr. Kanizsai Péter László
Dr. Varga Csaba
Dr. Pető Zoltán
Dr. Székely Andrea
Dr. Fazakas János
Dr. Várnai Réka
Introduction: Conditions that have similar initial presentations as sepsis may make early recognition of sepsis in an emergency room (ER) difficult.
Objectives: We investigated whether selected physiologic and metabolic parameters can be reliably used in the emergency department to differentiate sepsis from other disease states that mimic it, such as dehydration and stroke.
Results: Age, bicarbonate, HR, lactate, pH, and body temperature had U, V, W or reverse U-shaped associations with identifiable inflexion points, but the cutoff values we identified were slightly different from guideline cutoff values. In contrast to the guidelines, no inflexion points could be observed for the association of sepsis with SBP, DPB, MAP, and RR and therefore were treated as continuous variables. Compared to the guidelines-based model, the triage data-driven final model contained additional variables (age, pH, bicarbonate) and did not include lactate. The data-driven model identified about 85% of sepsis cases correctly, while the guidelines-based model identified only about 70% of sepsis cases correctly.
Conclusion: Our findings contribute to the growing body of evidence to find improved tools to identify sepsis at early time points, such as in the ER
