Use of quick sequential organ failure assessment score-based sepsis clinical decision support system may be helpful to predict sepsis development
1Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, 05505 Seoul, Republic of Korea
2Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, 05505 Seoul, Republic of Korea
3Medical Information Oﬃce, Asan Medical Center, 05505 Seoul, Republic of Korea
DOI: 10.22514/sv.2021.082 Vol.17,Issue 5,September 2021 pp.86-94
Submitted: 22 February 2021 Accepted: 15 March 2021
Published: 08 September 2021
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 Sepsis-3 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.
Quick SOFA; Compliance; Resuscitation bundle; Clinical decision support system; Sepsis
Youn-Jung Kim,Jae-Ho Lee,Sang-Wook Lee,Won Young Kim. Use of quick sequential organ failure assessment score-based sepsis clinical decision support system may be helpful to predict sepsis development. Signa Vitae. 2021. 17(5);86-94.
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