That is not good news!
"Two out of the four internationally-recommended screening tools used by emergency medical services are inadequate for recognising sepsis, according to new research presented at the European Emergency Medicine Congress ...
analysed data on 221,429 patients who were seen by emergency medical services (EMS) in Germany in 2016 outside of the hospital setting. They found that only one out of four screening tools had a reasonably accurate prediction rate for sepsis – NEWS-2 (National Early Warning Score). It was able to correctly predict 72.2% of all sepsis cases and correctly identified 81.4% of negative, non-septic, cases.
A second screening tool, qSOFA (quick Sequential Organ Failure Assessment), correctly predicted 96.6% of patients who did not have sepsis. ...
“We found that paramedics never documented a suspicion of sepsis, and emergency services physicians rarely did so, only documenting a suspicion in 0.1% of cases. The screening tools recommended in the Surviving Sepsis Campaign guidelines differed greatly in terms of which and how many patients were identified as possibly having sepsis.” ...
Our study found there was a similar incidence for sepsis, 1.6%, as for heart attacks, 2.6%, and stroke, 2.7%, in cases seen by emergency medical services. However, in terms of both percentages and absolute numbers, more patients died from sepsis than from heart attacks or stroke. Out of all cases with sepsis, 31.4% died within 30 days after being seen by emergency services, versus 13.4% and 11.8% respectively for heart attacks and stroke. ...
“We found that paramedics never documented a suspicion of sepsis, and emergency services physicians rarely did so, only documenting a suspicion in 0.1% of cases. The screening tools recommended in the Surviving Sepsis Campaign guidelines differed greatly in terms of which and how many patients were identified as possibly having sepsis.” ...
Our study found there was a similar incidence for sepsis, 1.6%, as for heart attacks, 2.6%, and stroke, 2.7%, in cases seen by emergency medical services. However, in terms of both percentages and absolute numbers, more patients died from sepsis than from heart attacks or stroke. Out of all cases with sepsis, 31.4% died within 30 days after being seen by emergency services, versus 13.4% and 11.8% respectively for heart attacks and stroke. ...
When they compared the performance of the four screening tools, the researchers found that NEWS-2 was the best for identifying patients with sepsis as it had a sensitivity (correctly predicted sepsis) of 72.2%, followed by MEWS, which had a sensitivity of 46.8% and a specificity (correctly predicted no sepsis) of 88.4%, SIRS (30.4% sensitivity, 93.8% specificity), and qSOFA (24% sensitivity, 96.6% specificity). Out of all EMS cases, 24.3% of cases were predicted to have sepsis by at least one of the screening tools, but only 0.9% were predicted to have sepsis by all four tools simultaneously. ..."
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