outcomes in sepsis, either as a replacement or a
complement. For example, a retrospective cohort
study of patients arriving at emergency care units
compared the value of using end-tidal carbon
dioxide with the qSOFA screening tool and
concluded that it allowed for a slightly better
prediction of mortality due to severe sepsis. 11
Another study of patients receiving intensive care
showed that hypothermia can complement the
role of qSOFA in the identification of patients at
risk of suffering multiple organ dysfunction or
death. 12 Moreover, a simplified version of qSOFA
using clinical parameters that are easy to obtain
in the hospital showed a performance level
similar to that of SOFA. 13 Despite these
encouraging data, the search for simpler scoring
systems with higher sensitivity continues.
Institutions must
continuously
strive to deliver
timely and
adequate care,
which might
involve easy-
to-apply and
non-invasive
screening
approaches
prior to hospital
admission
References
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There is some evidence that sepsis can be
potentially identified at an even earlier stage,
before hospital admission. 17 When paramedics
at an ambulance service in Scotland received
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decreased, with the majority of patients receiving
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some of the capacity and response issues caused
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Early warning scores for sepsis and
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Early warning systems have been developed to
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Compared with controls, sepsis survivors show
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It must not be forgotten that sepsis does not
only occur in the intensive care setting; therefore
institutions must continuously strive to deliver
timely and adequate care, which might involve
easy-to-apply and non-invasive screening
approaches prior to hospital admission. Failure
by health care professionals to fully adhere to
guidelines and inappropriate use of antimicrobial
agents leading to resistance are unfortunately
common, even in well-equipped facilities. In the
absence of an optimal biochemical marker and
laboratory test to guide the diagnosis of this
critical condition in clinical practice, continuing
education and protocol testing are crucial elements
in early sepsis diagnosis and stratification of
severity. Future research studies will certainly
provide solid and robust scientific evidence on the
accuracy of the currently available, and to be
developed, tools for early sepsis screening.
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