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Use of quick sequential organ failure assessment score-based sepsis clinical decision support system may be helpful to predict sepsis development

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Abstract
Objectives: A sepsis clinical decision support system (CDSS) can facilitate quicker sepsis detection and treatment and consequently improve outcomes. We developed a qSOFA-based sepsis CDSS and evaluated its impact on compliance with a 3-hour resuscitation bundle for patients with sepsis.

Methods: This before-and-after study included consecutive adult patients with suspected infection and qSOFA scores of >= 2 at their emergency department (ED) presentation of a tertiary care hospital. Sepsis was defined according to the Sepsis3 criteria. We evaluated the 3-hour resuscitation bundle compliance rate for control patients from July through August 2016, for patients using the qSOFA-based sepsis CDSS from September through December 2016, and the impact of the system using multivariable logistic regression analysis.

Results: Of 306 patients with suspected infection and positive qSOFA scores at presentation, 265 patients (86.6%) developed sepsis (including 71 patients with septic shock). The 3-hour resuscitation bundle compliance rate did not differ significantly between the patients before and after the routine implementation of the qSOFA-based sepsis CDSS (63.7% vs. 52.6%; P = 0.071). Multivariate analysis showed that age (AOR [adjusted odds ratio], 1.033; P = 0.002) and body temperature (AOR, 1.677; P < 0.001) were associated with bundle compliance.

Conclusions: Among patients with a positive qSOFA score at presentation, sepsis developed in 86.6%, which means the qSOFA-based sepsis CDSS may be helpful; however, it was not associated with improved bundle compliance. Future quality improvement studies with multifactorial, hospital-wide approaches using sepsis CDSS tools are warranted.
Author(s)
김원영이상욱김윤정이재호
Issued Date
2021
Type
Article
Keyword
Quick SOFAComplianceResuscitation bundleClinical decision support systemSepsis
DOI
10.22514/sv.2021.082
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7744
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_crossref_primary_10_22514_sv_2021_082&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Use%20of%20quick%20sequential%20organ%20failure%20assessment%20score-based%20sepsis%20clinical%20decision%20support%20system%20may%20be%20helpful%20to%20predict%20sepsis%20development&amp;offset=0&amp;pcAvailability=true
Publisher
SIGNA VITAE
Location
싱가포르
Language
한국어
ISSN
1334-5605
Citation Volume
17
Citation Number
5
Citation Start Page
86
Citation End Page
94
Appears in Collections:
Medicine > Medicine
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