Validation of sepsis screening tool using StO2 in emergency department patients.
BACKGROUND
Sepsis is a deleterious systemic response to an infection with a high incidence of morbidity and mortality, affecting more than a million patients a year in the US. The purpose of this study was to develop a screening tool for the early identification of sepsis in emergency department patients using readily available information at triage.


METHODS
This prospective, observational study took place at an academic tertiary referral hospital. Over a period of 10 wk, all patients who were seen at triage were screened for study enrollment. Inclusion criteria were adult (age≥18 y) nontrauma patients and exclusion criteria were prisoners and pregnant women. Using a Spot Check StO2 device to measure StO2 value, heart rate, respiratory rate, and temperature, these values were used to generate a cumulative screening score indicating whether a patient may have sepsis.


RESULTS
A total of 500 patients were screened. The incidence of sepsis in the present study population was 8.4%. The screening tool yielded a sensitivity of 85.7%, a specificity of 78.4%, a positive predictive value of 26.7%, and a negative predictive value of 98.4%.


CONCLUSIONS
Heart rate, respiratory rate, and temperature have good diagnostic potential for the early identification of sepsis among emergency department triage personnel. Additionally, early evidence suggests StO2 may play a complementary and synergistic role in the early identification of sepsis by triage personnel.
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), Houston, Texas.
Corbin E
CE
Goerlich
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), Houston, Texas.
Charles E
CE
Wade
Department of Emergency Medicine, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), Houston, Texas.
James J
JJ
McCarthy
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), Houston, Texas.
John B
JB
Holcomb
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), Houston, Texas. Electronic address: laura.j.moore@uth.tmc.edu.
Laura J
LJ
Moore
D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism; D014218:Triage
D010100:Oxygen
Emergency department; Emergency room; NIRS; Near infrared spectroscopy; Screening; Sepsis; Spot Check; StO(2); Systemic inflammatory response syndrome; Triage