The available criteria for different sepsis scoring systems in the emergency department— a retrospective assessment

Abstract

Objective: The goal of the study was to assess the criteria availability of eight sepsis scoring methods within 6 hours of triage in the emergency department (ED). Design: Retrospective data analysis study. Setting: ED of MedStar Washington Hospital Center (MWHC), a 912-bed urban, tertiary hospital. Patients: Adult (age ≥ 18 years) patients presenting to the MWHC ED between June 1, 2017 and May 31, 2018 and admitted with a diagnosis of severe sepsis with or without shock. Main Outcomes Measured: Availability of sepsis scoring criteria of eight different sepsis scoring methods at three time points—0 Hours (T0), 3 Hours (T1) and 6 Hours (T2) after arrival to the ED. Results: A total of 50 charts were reviewed, which included 23 (46%) males and 27 (54%) females. Forty-eight patients (96%) were Black or African American. Glasgow Coma Scale was available for all 50 patients at T0. Vital signs, except for temperature, were readily available (>90%) at T0. The majority of laboratory values relevant for sepsis scoring criteria were available (>90%) at T1, with exception to bilirubin (66%) and creatinine (80%). NEWS, PRESEP and qSOFA had greater than 90% criteria availability at triage. SOFA and SIRS consistently had the least percent of available criteria at all time points in the ED. Conclusion: The availability of patient data at different time points in a patient’s ED visit suggests that different scoring methods could be utilized to assess for sepsis as more patient information becomes available.