%PDF-1.6
%
1 0 obj
<>
endobj
2 0 obj
<>stream
Tamas Szakmany, Robert M. Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E. Hall, Welsh Digital Data Collection Platform Collaborators
Sepsis Prevalence and Outcome on the General Wards and Emergency Departments in Wales: Results of a Multi-Centre, Observational, Point Prevalence Study
www.plosone.org
www.plosone.org
endstream
endobj
3 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 12 0 R/Contents 13 0 R/TrimBox[0 0 612 792]>>
endobj
12 0 obj
[14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R]
endobj
14 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref001)>>
endobj
15 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref002)>>
endobj
16 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref003)>>
endobj
17 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref004)>>
endobj
18 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref005)>>
endobj
19 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref004)>>
endobj
20 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref006)>>
endobj
21 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref007)>>
endobj
22 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref008)>>
endobj
23 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref010)>>
endobj
24 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref003)>>
endobj
13 0 obj
[25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R]
endobj
25 0 obj
<>stream
q
0.45 0.36 0.35 0.01 k
0 w
575.9997 652.2299 m
199.9998 652.2299 l
199.9998 652.7299 l
575.9997 652.7299 l
f*
0.83 0.64 0.02 0 k
450.085 536.9386 m
454.8472 536.9386 l
h
f*
290.6079 497.9339 m
295.3701 497.9339 l
h
f*
203.4142 471.9118 m
208.1764 471.9118 l
h
f*
285.1087 393.9024 m
289.8709 393.9024 l
h
f*
549.6945 380.9197 m
554.4 380.9197 l
h
f*
487.3323 328.9323 m
492.0945 328.9323 l
h
f*
494.3622 328.9323 m
499.1244 328.9323 l
h
f*
501.3921 328.9323 m
506.1543 328.9323 l
h
f*
411.1937 237.9402 m
415.9559 237.9402 l
h
f*
421.115 237.9402 m
430.6394 237.9402 l
h
f*
260.0504 159.9307 m
264.7559 159.9307 l
h
f*
0 g
1 j
1 J
9.5 0 0 9.5 200.0125 707.7543 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(independent)Tj
5.6513 0 Td
(variables)Tj
4.1654 0 Td
(suggesting)Tj
5.0009 0 Td
(the)Tj
1.5934 0 Td
(diagnosis)Tj
4.3862 0 Td
(of)Tj
1.0444 0 Td
(sepsis.)Tj
3.3001 0 Td
(We)Tj
1.7127 0 Td
(observed)Tj
4.2848 0 Td
(that)Tj
1.8738 0 Td
(sepsis)Tj
3.0256 0 Td
(is)Tj
0.931 0 Td
(more)Tj
-36.9696 -1.474 Td
(prevalent)Tj
4.2788 0 Td
(in)Tj
0.9846 0 Td
(the)Tj
1.5934 0 Td
(general)Tj
3.509 0 Td
(ward)Tj
2.3632 0 Td
(and)Tj
1.8678 0 Td
(ED)Tj
1.5994 0 Td
(than)Tj
2.1424 0 Td
(previously)Tj
4.6667 0 Td
(suggested)Tj
4.7801 0 Td
(before)Tj
3.0196 0 Td
(and)Tj
1.8679 0 Td
(that)Tj
1.8738 0 Td
(screening)Tj
-34.5467 -1.474 Td
(and)Tj
1.8619 0 Td
(effective)Tj
3.9088 0 Td
(treatment)Tj
4.4101 0 Td
(for)Tj
1.3725 0 Td
(sepsis)Tj
3.0256 0 Td
(and)Tj
1.8619 0 Td
(severe)Tj
3.1927 0 Td
(sepsis)Tj
3.0197 0 Td
(is)Tj
0.9309 0 Td
(far)Tj
1.3786 0 Td
(from)Tj
2.202 0 Td
(being)Tj
2.6318 0 Td
(operationalize)Tj
6.1407 0 Td
(d)Tj
0.7638 0 Td
(in)Tj
0.9847 0 Td
(this)Tj
-37.6857 -1.474 Td
(environment,)Tj
5.9378 0 Td
(leading)Tj
3.3956 0 Td
(to)Tj
1.0443 0 Td
(high)Tj
2.0827 0 Td
(90)Tj
1.3129 0 Td
(days)Tj
2.3154 0 Td
(mortality.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 593.9716 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Background)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 577.0204 cm
BT
/F9 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Sepsis)Tj
2.6248 0 Td
(is)Tj
0.8447 0 Td
(a)Tj
0.6577 0 Td
(systemic)Tj
3.6283 0 Td
(response)Tj
3.7304 0 Td
(to)Tj
1.0261 0 Td
(infection,)Tj
4.0195 0 Td
(which)Tj
2.6475 0 Td
(causes)Tj
2.7496 0 Td
(a)Tj
0.6577 0 Td
(potentially)Tj
4.4617 0 Td
(damaging)Tj
4.1782 0 Td
(inflammatory)Tj
-31.2262 -1.3039 Td
(response.)Tj
3.9571 0 Td
(Severe)Tj
2.7949 0 Td
(sepsis)Tj
2.5058 0 Td
(is)Tj
0.8504 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(sepsis)Tj
2.5115 0 Td
(leading)Tj
3.1294 0 Td
(to)Tj
1.0262 0 Td
(dysfunction)Tj
4.9719 0 Td
(of)Tj
1.0148 0 Td
(one)Tj
1.7008 0 Td
(or)Tj
1.0998 0 Td
(more)Tj
2.3414 0 Td
(organ)Tj
2.5455 0 Td
(sys-)Tj
-34.6901 -1.2982 Td
(tems.)Tj
2.347 0 Td
(Successful)Tj
4.2746 0 Td
(management)Tj
5.4369 0 Td
(of)Tj
1.0148 0 Td
(sepsis)Tj
2.5114 0 Td
(requires)Tj
3.4696 0 Td
(prompt)Tj
3.2542 0 Td
(recognition)Tj
4.8472 0 Td
(and)Tj
1.7291 0 Td
(immediate)Tj
4.5014 0 Td
(response)Tj
-33.3862 -1.2983 Td
(with)Tj
1.9955 0 Td
(appropriate)Tj
4.8813 0 Td
(escalation)Tj
4.1612 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8708 0 Td
(to)Tj
1.0262 0 Td
(Critical)Tj
3.1918 0 Td
(Care)Tj
2.1089 0 Td
(if)Tj
0.7767 0 Td
(required)Tj
3.6397 0 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
(].)Tj
-23.4707 -1.3039 Td
(In)Tj
1.1111 0 Td
(the)Tj
1.4684 0 Td
(UK)Tj
1.6327 0 Td
(sepsis)Tj
2.5115 0 Td
(is)Tj
0.8447 0 Td
(estimated)Tj
4.0762 0 Td
(to)Tj
1.0205 0 Td
(be)Tj
1.1508 0 Td
(responsible)Tj
4.7565 0 Td
(for)Tj
1.3833 0 Td
(the)Tj
1.474 0 Td
(deaths)Tj
2.7893 0 Td
(of)Tj
1.0148 0 Td
(44,000)Tj
2.8233 0 Td
(people)Tj
2.8573 0 Td
(every)Tj
2.3471 0 Td
(year)Tj
-34.4577 -1.2983 Td
(and)Tj
1.7291 0 Td
(to)Tj
1.0261 0 Td
(cost)Tj
1.8085 0 Td
(the)Tj
1.4683 0 Td
(NHS)Tj
2.1997 0 Td
(2.5)Tj
1.8709 0 Td
(billion)Tj
2.8119 0 Td
(and)Tj
1.7291 0 Td
(for)Tj
1.389 0 Td
(Wales)Tj
2.6475 0 Td
(this)Tj
1.6725 0 Td
(could)Tj
2.4548 0 Td
(equate)Tj
2.8346 0 Td
(to)Tj
1.0261 0 Td
(a)Tj
0.652 0 Td
(figure)Tj
2.5625 0 Td
(of)Tj
1.0148 0 Td
(1800)Tj
2.1203 0 Td
(deaths)Tj
2.7949 0 Td
(and)Tj
-35.8126 -1.2982 Td
(a)Tj
0.6519 0 Td
(cost)Tj
1.8085 0 Td
(of)Tj
1.0148 0 Td
(125)Tj
2.126 0 Td
(million)Tj
3.1181 0 Td
([)Tj
0.83 0.64 0.02 0 k
(2)Tj
0 g
(].)Tj
1.6044 0 Td
(However,)Tj
4.0762 0 Td
(accurate)Tj
3.5546 0 Td
(data)Tj
1.9162 0 Td
(collection)Tj
4.1102 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(non-Critical)Tj
5.142 0 Td
(Care)Tj
2.1147 0 Td
(setting)Tj
2.8799 0 Td
(is)Tj
-36.6233 -1.304 Td
(still)Tj
1.6327 0 Td
(under)Tj
2.6079 0 Td
(development)Tj
5.4028 0 Td
(in)Tj
1.0318 0 Td
(Wales)Tj
2.6418 0 Td
(and)Tj
1.7235 0 Td
(it)Tj
0.7767 0 Td
(is)Tj
0.8447 0 Td
(thought)Tj
3.3619 0 Td
(that)Tj
1.7688 0 Td
(the)Tj
1.4626 0 Td
(real)Tj
1.6895 0 Td
(number)Tj
3.4129 0 Td
(is)Tj
0.839 0 Td
(likely)Tj
2.3471 0 Td
(to)Tj
1.0205 0 Td
(be)Tj
1.1395 0 Td
(far)Tj
1.3096 0 Td
(higher)Tj
-35.0133 -1.2982 Td
([)Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(].)Tj
1.5987 0 Td
(Sepsis)Tj
2.6248 0 Td
(is)Tj
0.8504 0 Td
(a)Tj
0.652 0 Td
(major)Tj
2.6079 0 Td
(cause)Tj
2.3924 0 Td
(of)Tj
1.0148 0 Td
(avoidable)Tj
4.0195 0 Td
(mortality)Tj
3.9174 0 Td
(and)Tj
1.7292 0 Td
(it)Tj
0.788 0 Td
(is)Tj
0.8447 0 Td
(imperative)Tj
4.4957 0 Td
(that)Tj
1.7802 0 Td
(we)Tj
1.3266 0 Td
(understand)Tj
4.7905 0 Td
(the)Tj
-35.4328 -1.2983 Td
(size)Tj
1.6837 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(problem)Tj
3.6113 0 Td
(within)Tj
2.8119 0 Td
(Wales)Tj
2.6532 0 Td
(so)Tj
1.0885 0 Td
(that)Tj
1.7745 0 Td
(we)Tj
1.3323 0 Td
(can)Tj
1.6214 0 Td
(improve)Tj
3.583 0 Td
(the)Tj
1.4683 0 Td
(quality)Tj
2.9593 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(received)Tj
3.5319 0 Td
(by)Tj
1.1849 0 Td
(our)Tj
-34.6731 -1.2983 Td
(patients.)Tj
1.1962 -1.3039 Td
(Through)Tj
3.7587 0 Td
(participation)Tj
5.3744 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(1000)Tj
2.1203 0 Td
(Lives)Tj
2.2621 0 Td
(Plus)Tj
1.9162 0 Td
(RRAILS/Sepsis)Tj
6.2362 0 Td
(Wales)Tj
2.6475 0 Td
(Programme,)Tj
5.2214 0 Td
(all)Tj
1.1452 0 Td
(Welsh)Tj
-34.384 -1.2982 Td
(healthcare)Tj
4.3313 0 Td
(organizations)Tj
5.6409 0 Td
(have)Tj
2.0579 0 Td
(reached)Tj
3.3505 0 Td
(a)Tj
0.6577 0 Td
(consensus)Tj
4.2803 0 Td
(on)Tj
1.2755 0 Td
(use)Tj
1.5307 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(Sepsis)Tj
2.6248 0 Td
(6)Tj
0.6974 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(optimum)Tj
3.9798 0 Td
(treat-)Tj
-35.3931 -1.2983 Td
(ment)Tj
2.3073 0 Td
(protocol)Tj
3.6 0 Td
(with)Tj
1.9956 0 Td
(the)Tj
1.4683 0 Td
(aim)Tj
1.7405 0 Td
(that)Tj
1.7801 0 Td
(all)Tj
1.1452 0 Td
(elements)Tj
3.7644 0 Td
(are)Tj
1.4513 0 Td
(delivered)Tj
3.8835 0 Td
(within)Tj
2.8119 0 Td
(1)Tj
0.6974 0 Td
(hour)Tj
2.1543 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(patient)Tj
3.0104 0 Td
(identi-)Tj
-34.2933 -1.3039 Td
(fied)Tj
1.7234 0 Td
(as)Tj
1.0148 0 Td
(having)Tj
2.9197 0 Td
(sepsis)Tj
2.5114 0 Td
([)Tj
0.83 0.64 0.02 0 k
(4)Tj
0 g
(].)Tj
1.5988 0 Td
(In)Tj
1.1112 0 Td
(Wales,)Tj
2.8743 0 Td
(one)Tj
1.7007 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(cornerstones)Tj
5.3631 0 Td
(of)Tj
1.0148 0 Td
(identifying)Tj
4.5751 0 Td
(sepsis)Tj
2.5115 0 Td
(patients)Tj
3.3675 0 Td
(is)Tj
0.8504 0 Td
(the)Tj
-35.6199 -1.2983 Td
(use)Tj
1.5306 0 Td
(of)Tj
1.0148 0 Td
(a)Tj
0.652 0 Td
(universally)Tj
4.5581 0 Td
(applied)Tj
3.1521 0 Td
(track)Tj
2.245 0 Td
(and)Tj
1.7291 0 Td
(trigger)Tj
2.88 0 Td
(system,)Tj
3.1635 0 Td
(the)Tj
1.474 0 Td
(National)Tj
3.6907 0 Td
(Early)Tj
2.296 0 Td
(Warning)Tj
3.8211 0 Td
(Score)Tj
2.4208 0 Td
([)Tj
0.83 0.64 0.02 0 k
(5)Tj
0 g
(].)Tj
1.5987 0 Td
(Its)Tj
-36.2265 -1.2982 Td
(use)Tj
1.5306 0 Td
(has)Tj
1.5421 0 Td
(been)Tj
2.126 0 Td
(embedded)Tj
4.3993 0 Td
(in)Tj
1.0318 0 Td
(clinical)Tj
3.0784 0 Td
(practice,)Tj
3.6057 0 Td
(however)Tj
3.6113 0 Td
(it)Tj
0.7823 0 Td
(has)Tj
1.5421 0 Td
(never)Tj
2.4434 0 Td
(been)Tj
2.126 0 Td
(investigated)Tj
4.9889 0 Td
(as)Tj
1.0148 0 Td
(to)Tj
-33.8227 -1.304 Td
(whether)Tj
3.4752 0 Td
(the)Tj
1.4683 0 Td
(preset)Tj
2.6136 0 Td
(trigger)Tj
2.8856 0 Td
(levels)Tj
2.3754 0 Td
(for)Tj
1.3833 0 Td
(escalation)Tj
4.1669 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(are)Tj
1.4456 0 Td
(appropriate)Tj
4.8813 0 Td
(for)Tj
1.3833 0 Td
(sepsis)Tj
2.5115 0 Td
(patients.)Tj
-30.2795 -1.2982 Td
(Despite)Tj
3.2484 0 Td
(evidence)Tj
3.7134 0 Td
(demonstrating)Tj
6.0888 0 Td
(the)Tj
1.4683 0 Td
(value)Tj
2.3074 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(Sepsis)Tj
2.6306 0 Td
(6)Tj
0.6916 0 Td
(initiative,)Tj
3.9742 0 Td
(marked)Tj
3.2938 0 Td
(differences)Tj
-31.0958 -1.2983 Td
(remain)Tj
3.084 0 Td
(between)Tj
3.5263 0 Td
(hospitals)Tj
3.7417 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(delivery)Tj
3.3846 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8765 0 Td
(for)Tj
1.3833 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
2.0013 0 Td
(sepsis)Tj
2.5115 0 Td
([)Tj
0.83 0.64 0.02 0 k
(4)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
(6)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(].)Tj
2.999 0 Td
(Reviewing)Tj
4.3767 0 Td
(the)Tj
-35.773 -1.2983 Td
(potential)Tj
3.7587 0 Td
(barriers)Tj
3.3278 0 Td
(to)Tj
1.0262 0 Td
(effective)Tj
3.5092 0 Td
(application)Tj
4.6772 0 Td
(of)Tj
1.0148 0 Td
(measures)Tj
3.9458 0 Td
(will)Tj
1.6611 0 Td
(identify)Tj
3.2938 0 Td
(an)Tj
1.2019 0 Td
(important)Tj
4.2859 0 Td
(opportunity)Tj
5.0343 0 Td
(to)Tj
-36.7367 -1.3039 Td
(reduce)Tj
2.9139 0 Td
(sepsis-induced)Tj
6.1115 0 Td
(mortality)Tj
3.9118 0 Td
(further.)Tj
3.2541 0 Td
(To)Tj
1.338 0 Td
(inform)Tj
3.0217 0 Td
(current)Tj
3.1861 0 Td
(and)Tj
1.7291 0 Td
(future)Tj
2.6589 0 Td
(quality)Tj
2.9537 0 Td
(improvement)Tj
-31.0788 -1.2982 Td
(efforts)Tj
2.7552 0 Td
(in)Tj
1.0375 0 Td
(sepsis,)Tj
2.7326 0 Td
(there)Tj
2.2677 0 Td
(is)Tj
0.8447 0 Td
(a)Tj
0.6576 0 Td
(need)Tj
2.143 0 Td
(to)Tj
1.0261 0 Td
(better)Tj
2.5399 0 Td
(understand)Tj
4.7905 0 Td
(how)Tj
1.9389 0 Td
(widely)Tj
2.8233 0 Td
(and)Tj
1.7291 0 Td
(well)Tj
1.8198 0 Td
(the)Tj
1.4683 0 Td
(evidence-based)Tj
-30.5742 -1.2983 Td
(bundles)Tj
3.3618 0 Td
(are)Tj
1.4457 0 Td
(used)Tj
2.0636 0 Td
(in)Tj
1.0318 0 Td
(different)Tj
3.6567 0 Td
(hospitals)Tj
3.7417 0 Td
(within)Tj
2.8119 0 Td
(the)Tj
1.4684 0 Td
(same)Tj
2.262 0 Td
(healthcare)Tj
4.3256 0 Td
(system.)Tj
3.1635 0 Td
(The)Tj
1.7858 0 Td
(recent)Tj
-31.1185 -1.3039 Td
(IMPRESS)Tj
4.1498 0 Td
(study)Tj
2.3868 0 Td
(shed)Tj
2.0579 0 Td
(some)Tj
2.3244 0 Td
(light)Tj
2.024 0 Td
(on)Tj
1.2699 0 Td
(international)Tj
5.4084 0 Td
(differences)Tj
4.5638 0 Td
(observed)Tj
3.7927 0 Td
(in)Tj
1.0318 0 Td
(sepsis)Tj
2.5058 0 Td
(care)Tj
1.8709 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.4683 0 Td
(crit-)Tj
-35.8863 -1.2983 Td
(ical)Tj
1.5873 0 Td
(care)Tj
1.8766 0 Td
(setting.)Tj
3.1067 0 Td
(However)Tj
3.8494 0 Td
(there)Tj
2.2677 0 Td
(has)Tj
1.5421 0 Td
(not)Tj
1.5704 0 Td
(been)Tj
2.1259 0 Td
(a)Tj
0.652 0 Td
(recent)Tj
2.7099 0 Td
(major)Tj
2.6079 0 Td
(study)Tj
2.3867 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.474 0 Td
(problem)Tj
3.6113 0 Td
(on)Tj
1.2756 0 Td
(general)Tj
-33.6583 -1.2983 Td
(wards,)Tj
2.8232 0 Td
(the)Tj
1.4684 0 Td
(last)Tj
1.559 0 Td
(available)Tj
3.668 0 Td
(data)Tj
1.9106 0 Td
(being)Tj
2.4321 0 Td
(over)Tj
1.9786 0 Td
(10)Tj
1.1735 0 Td
(years)Tj
2.262 0 Td
(old)Tj
1.5024 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(10)Tj
0 g
(].)Tj
-19.5816 -1.3039 Td
(We)Tj
1.61 0 Td
(have)Tj
2.0636 0 Td
(recently)Tj
3.4073 0 Td
(reported)Tj
3.6623 0 Td
(the)Tj
1.4683 0 Td
(results)Tj
2.8063 0 Td
(of)Tj
1.0148 0 Td
(our)Tj
1.6271 0 Td
(point)Tj
2.3584 0 Td
(prevalence)Tj
4.4901 0 Td
(feasibility)Tj
4.0308 0 Td
(study)Tj
2.3924 0 Td
(in)Tj
1.0318 0 Td
(Wales.)Tj
-33.1594 -1.2982 Td
(They)Tj
2.2336 0 Td
(indicated)Tj
3.9402 0 Td
(that)Tj
1.7801 0 Td
(out)Tj
1.5534 0 Td
(of)Tj
1.0148 0 Td
(2716)Tj
2.1203 0 Td
(in-patients)Tj
4.5354 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(four)Tj
1.9105 0 Td
(hospitals)Tj
3.7418 0 Td
(during)Tj
2.9253 0 Td
(the)Tj
1.474 0 Td
(24-hour)Tj
3.4526 0 Td
(study)Tj
-33.1878 -1.2983 Td
(period,)Tj
3.0557 0 Td
(51)Tj
1.1735 0 Td
(\(1.9%\))Tj
2.8346 0 Td
(had)Tj
1.7065 0 Td
(signs)Tj
2.2223 0 Td
(of)Tj
1.0148 0 Td
(infection,)Tj
4.0195 0 Td
(classified)Tj
3.8211 0 Td
(as)Tj
1.0148 0 Td
(sepsis,)Tj
2.7326 0 Td
(and)Tj
1.7291 0 Td
(21)Tj
1.1736 0 Td
(\(0.8%\))Tj
2.8346 0 Td
(had)Tj
1.7064 0 Td
(infection)Tj
3.7928 0 Td
(and)Tj
-34.8319 -1.3039 Td
(organ)Tj
2.5454 0 Td
(dysfunction.)Tj
5.1988 0 Td
(Of)Tj
1.2529 0 Td
(the)Tj
1.4683 0 Td
(51)Tj
1.1735 0 Td
(patients)Tj
3.3676 0 Td
(with)Tj
1.9955 0 Td
(sepsis,)Tj
2.7383 0 Td
(critical)Tj
2.948 0 Td
(care)Tj
1.8765 0 Td
(clinicians)Tj
4.0025 0 Td
(saw)Tj
1.7008 0 Td
(only)Tj
1.9786 0 Td
(seven,)Tj
2.6532 0 Td
(of)Tj
-34.8999 -1.2983 Td
(which)Tj
2.6475 0 Td
(two)Tj
1.7121 0 Td
(patients)Tj
3.3675 0 Td
(were)Tj
2.1203 0 Td
(admitted)Tj
3.8155 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.474 0 Td
(ICU.)Tj
2.1827 0 Td
(Three)Tj
2.5795 0 Td
(patients)Tj
3.3675 0 Td
(received)Tj
3.532 0 Td
(the)Tj
1.4683 0 Td
(full)Tj
1.5307 0 Td
(Sepsis)Tj
2.6249 0 Td
(6)Tj
0.6973 0 Td
(bundle)Tj
-34.1459 -1.2982 Td
(within)Tj
2.8119 0 Td
(1)Tj
0.6973 0 Td
(hour)Tj
2.1543 0 Td
([)Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(].)Tj
1.5988 0 Td
(The)Tj
1.7801 0 Td
(new)Tj
1.8765 0 Td
(sepsis)Tj
2.5115 0 Td
(definitions)Tj
4.5241 0 Td
(were)Tj
2.126 0 Td
(published)Tj
4.1215 0 Td
(in)Tj
1.0375 0 Td
(2016,)Tj
2.347 0 Td
(which)Tj
2.6476 0 Td
(potentially)Tj
4.4617 0 Td
(has)Tj
-34.6958 -1.2983 Td
(changed)Tj
3.5716 0 Td
(the)Tj
1.4683 0 Td
(baseline)Tj
3.4299 0 Td
(for)Tj
1.3833 0 Td
(sepsis)Tj
2.5115 0 Td
(incidence,)Tj
4.2973 0 Td
(essentially)Tj
4.2859 0 Td
(removing)Tj
4.0762 0 Td
(the)Tj
1.4741 0 Td
(severe)Tj
3.067 0 Td
(sepsis)Tj
2.9027 0 Td
(category.)Tj
-32.4678 -1.3039 Td
(However)Tj
3.8437 0 Td
(our)Tj
1.6157 0 Td
(study)Tj
2.3811 0 Td
(predated)Tj
3.7361 0 Td
(this)Tj
1.6667 0 Td
(change)Tj
3.0331 0 Td
(and)Tj
1.7234 0 Td
(all)Tj
1.1396 0 Td
(Welsh)Tj
2.7325 0 Td
(hospitals)Tj
3.7304 0 Td
(continued)Tj
4.286 0 Td
(to)Tj
1.0148 0 Td
(use)Tj
1.525 0 Td
(the)Tj
1.4627 0 Td
(2012)Tj
2.1146 0 Td
(def-)Tj
-36.0054 -1.2983 Td
(inition)Tj
2.9196 0 Td
(of)Tj
1.0148 0 Td
(sepsis)Tj
2.5115 0 Td
(during)Tj
2.931 0 Td
(the)Tj
1.4683 0 Td
(study)Tj
2.3925 0 Td
(period.)Tj
-12.0415 -1.2983 Td
(Based)Tj
2.5511 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(lessons)Tj
3.0274 0 Td
(learnt)Tj
2.5399 0 Td
(from)Tj
2.2053 0 Td
(the)Tj
1.474 0 Td
(feasibility)Tj
4.0308 0 Td
(pilot)Tj
2.058 0 Td
(we)Tj
1.3266 0 Td
(conducted)Tj
4.4277 0 Td
(a)Tj
0.6519 0 Td
(point-prevalence)Tj
6.9789 0 Td
(study)Tj
-35.2117 -1.3039 Td
(across)Tj
2.6758 0 Td
(Wales)Tj
2.6533 0 Td
(in)Tj
1.0318 0 Td
(2015,)Tj
2.347 0 Td
(utilizing)Tj
3.5206 0 Td
(electronic)Tj
4.1556 0 Td
(data)Tj
1.9105 0 Td
(collection,)Tj
4.337 0 Td
(real-time)Tj
3.8551 0 Td
(data)Tj
1.9162 0 Td
(monitoring)Tj
4.8189 0 Td
(and)Tj
1.7291 0 Td
(addi-)Tj
-34.9509 -1.2982 Td
(tional)Tj
2.5171 0 Td
(support)Tj
3.3222 0 Td
(for)Tj
1.389 0 Td
(the)Tj
1.4683 0 Td
(data)Tj
1.9105 0 Td
(collectors.)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 229.8897 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Size)Tj
2.133 0 Td
(of)Tj
1.0347 0 Td
(Sepsis)Tj
3.1748 0 Td
(in)Tj
0.978 0 Td
(Wales:)Tj
3.2315 0 Td
(Point)Tj
2.4591 0 Td
(Prevalenc)Tj
4.3654 0 Td
(e)Tj
0.7653 0 Td
(Study)Tj
2.7426 0 Td
(on)Tj
1.311 0 Td
(the)Tj
1.5874 0 Td
(General)Tj
3.7134 0 Td
(Wards)Tj
3.0686 0 Td
(and)Tj
1.8567 0 Td
(Emergenc)Tj
4.4858 0 Td
(y)Tj
0.7158 0 Td
(Departments)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0167)Tj
3.5434 0 Td
(230)Tj
2.6362 0 Td
(December)Tj
4.7622 0 Td
(1,)Tj
1.0418 0 Td
(2016)Tj
37.2971 0 Td
(2)Tj
0.7654 0 Td
(/)Tj
0.496 0 Td
(12)Tj
/F10 1 Tf
-0.025 Tc
-66.402 84.0904 Td
(Competing)Tj
4.3795 0 Td
(Interests)Tj
3.3307 0 Td
(:)Tj
/F11 1 Tf
0.4819 0 Td
(The)Tj
1.5875 0 Td
(authors)Tj
3.0401 0 Td
(have)Tj
1.963 0 Td
(declared)Tj
-14.7827 -1.3748 Td
(that)Tj
1.6228 0 Td
(no)Tj
1.1693 0 Td
(competing)Tj
4.1599 0 Td
(interests)Tj
ET
endstream
endobj
26 0 obj
<>stream
endstream
endobj
27 0 obj
<>stream
endstream
endobj
28 0 obj
<>stream
endstream
endobj
29 0 obj
<>stream
endstream
endobj
30 0 obj
<>stream
endstream
endobj
31 0 obj
<>stream
endstream
endobj
32 0 obj
<>stream
endstream
endobj
33 0 obj
<>stream
endstream
endobj
34 0 obj
<>stream
endstream
endobj
35 0 obj
<>stream
BT
10.3394 82.7156 Td
(exist.)Tj
ET
Q
endstream
endobj
36 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 39 0 R/Contents 40 0 R/TrimBox[0 0 612 792]>>
endobj
39 0 obj
[41 0 R 42 0 R]
endobj
41 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref001)>>
endobj
42 0 obj
<>/Border[0 0 0]/Dest(Rpone.0167230.ref011)>>
endobj
40 0 obj
[43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R]
endobj
43 0 obj
<>stream
q
0.83 0.64 0.02 0 k
203.4142 527.0173 m
208.1764 527.0173 l
h
f*
353.8772 383.9811 m
363.4016 383.9811 l
h
f*
0 g
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 706.0535 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Methods)Tj
/F0 1 Tf
0 -1.4976 Td
(Study)Tj
2.7543 0 Td
(design)Tj
3.1229 0 Td
(and)Tj
1.8661 0 Td
(participants)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 671.074 cm
BT
/F9 1 Tf
1 TL
-0.004 Tc
0 0 Td
(This)Tj
1.9842 0 Td
(was)Tj
1.7008 0 Td
(a)Tj
0.6519 0 Td
(multicenter,)Tj
5.0967 0 Td
(prospective,)Tj
5.0059 0 Td
(observational)Tj
5.5843 0 Td
(study)Tj
2.3867 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(prevalence)Tj
4.49 0 Td
(of)Tj
1.0148 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
-33.766 -1.2982 Td
(either)Tj
2.5284 0 Td
(sepsis)Tj
2.5115 0 Td
(or)Tj
1.0999 0 Td
(severe)Tj
2.6758 0 Td
(sepsis)Tj
2.5115 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(general)Tj
3.1351 0 Td
(wards.)Tj
2.8233 0 Td
(On)Tj
1.5137 0 Td
(17)Tj
1.1736 0 Td
(June)Tj
2.0466 0 Td
(2015)Tj
2.1259 0 Td
(\(0800)Tj
2.4605 0 Td
(to)Tj
1.0261 0 Td
(0759)Tj
2.1203 0 Td
(hours)Tj
2.5172 0 Td
(the)Tj
-35.0133 -1.3039 Td
(following)Tj
3.9798 0 Td
(day\),)Tj
2.1996 0 Td
(consecutive)Tj
4.8813 0 Td
(patients)Tj
3.3675 0 Td
(presenting)Tj
4.4447 0 Td
(to)Tj
1.0205 0 Td
(the)Tj
1.474 0 Td
(Emergency)Tj
4.7168 0 Td
(Department)Tj
5.091 0 Td
(\(ED\))Tj
2.2053 0 Td
(or)Tj
1.0999 0 Td
(being)Tj
-34.4804 -1.2983 Td
(cared)Tj
2.398 0 Td
(for)Tj
1.389 0 Td
(in)Tj
1.0318 0 Td
(an)Tj
1.2019 0 Td
(acute)Tj
2.3301 0 Td
(in-patient)Tj
4.1725 0 Td
(ward)Tj
2.2394 0 Td
(setting)Tj
2.88 0 Td
(with)Tj
1.9956 0 Td
(sepsis)Tj
2.5114 0 Td
(or)Tj
1.0999 0 Td
(severe)Tj
2.6759 0 Td
(sepsis)Tj
2.5114 0 Td
(were)Tj
2.1203 0 Td
(enrolled.)Tj
3.7417 0 Td
(This)Tj
-34.2989 -1.2983 Td
(date)Tj
1.9048 0 Td
(was)Tj
1.6951 0 Td
(selected)Tj
3.3506 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(medical)Tj
3.3619 0 Td
(student)Tj
3.2031 0 Td
(data)Tj
1.9162 0 Td
(collectors)Tj
4.0252 0 Td
(were)Tj
2.1259 0 Td
(available)Tj
3.6624 0 Td
(during)Tj
2.931 0 Td
(this)Tj
1.6724 0 Td
(period)Tj
2.8346 0 Td
(and)Tj
1.7292 0 Td
(it)Tj
-36.8955 -1.2982 Td
(also)Tj
1.7688 0 Td
(represented)Tj
4.9095 0 Td
(an)Tj
1.2019 0 Td
(average)Tj
4.0082 0 Td
(day)Tj
1.6384 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(Welsh)Tj
2.7439 0 Td
(NHS.)Tj
2.4208 0 Td
(The)Tj
1.7858 0 Td
(data)Tj
1.9106 0 Td
(collectors)Tj
4.0308 0 Td
(systematically)Tj
-28.9245 -1.3039 Td
(screened)Tj
3.719 0 Td
(every)Tj
2.3527 0 Td
(patient)Tj
3.0047 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(acute)Tj
2.3301 0 Td
(in-patient)Tj
4.1726 0 Td
(wards)Tj
2.5965 0 Td
(within)Tj
2.812 0 Td
(4)Tj
0.6973 0 Td
(hours)Tj
2.5171 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(study)Tj
2.3867 0 Td
(start.)Tj
2.211 0 Td
(The)Tj
-34.0268 -1.2983 Td
(medical)Tj
3.3618 0 Td
(student)Tj
3.2031 0 Td
(data)Tj
1.9163 0 Td
(collectors)Tj
4.0251 0 Td
(screened)Tj
3.7247 0 Td
(all)Tj
1.1452 0 Td
(patients)Tj
3.3676 0 Td
(with)Tj
1.9955 0 Td
(NEWS)Tj
/F8 1 Tf
0 Tc
()Tj
/F9 1 Tf
-0.004 Tc
(3)Tj
4.218 0 Td
(for)Tj
1.3833 0 Td
(presence)Tj
3.7133 0 Td
(of)Tj
1.0148 0 Td
(2)Tj
0.6973 0 Td
(or)Tj
1.0942 0 Td
(more)Tj
-34.8602 -1.2983 Td
(SIRS)Tj
2.1316 0 Td
(criteria.)Tj
3.2995 0 Td
(To)Tj
1.3379 0 Td
(define)Tj
2.6986 0 Td
(sepsis,)Tj
2.7383 0 Td
(clinical)Tj
3.0784 0 Td
(teams)Tj
2.5511 0 Td
(had)Tj
1.7121 0 Td
(to)Tj
1.0262 0 Td
(have)Tj
2.0579 0 Td
(a)Tj
0.6577 0 Td
(high)Tj
2.0069 0 Td
(clinical)Tj
3.0727 0 Td
(suspicion)Tj
4.0025 0 Td
(of)Tj
1.0148 0 Td
(an)Tj
1.2019 0 Td
(infec-)Tj
-34.5881 -1.3039 Td
(tion)Tj
1.8311 0 Td
(\(documented)Tj
5.5786 0 Td
(as)Tj
1.0034 0 Td
(such)Tj
2.0523 0 Td
(in)Tj
1.0261 0 Td
(the)Tj
1.4627 0 Td
(medical)Tj
3.3505 0 Td
(or)Tj
1.0885 0 Td
(nursing)Tj
3.2995 0 Td
(notes\),)Tj
2.914 0 Td
(together)Tj
3.5263 0 Td
(with)Tj
1.9899 0 Td
(a)Tj
0.6463 0 Td
(systemic)Tj
3.617 0 Td
(inflamma-)Tj
-33.3862 -1.2983 Td
(tory)Tj
1.8481 0 Td
(response)Tj
3.7361 0 Td
(\(sepsis\))Tj
3.1918 0 Td
(and)Tj
1.7291 0 Td
(evidence)Tj
3.7133 0 Td
(of)Tj
1.0148 0 Td
(acute)Tj
2.3244 0 Td
(organ)Tj
2.5455 0 Td
(dysfunction)Tj
4.972 0 Td
(and/or)Tj
2.9423 0 Td
(shock)Tj
2.5342 0 Td
(\(severe)Tj
3.016 0 Td
(sepsis\))Tj
-33.5676 -1.2982 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
(].)Tj
1.5987 0 Td
(Patients)Tj
3.4129 0 Td
(were)Tj
2.1203 0 Td
(excluded)Tj
3.787 0 Td
(if)Tj
0.7711 0 Td
(they)Tj
1.9275 0 Td
(were)Tj
2.1203 0 Td
(less)Tj
1.6157 0 Td
(than)Tj
2.024 0 Td
(18)Tj
1.1735 0 Td
(years)Tj
2.262 0 Td
(of)Tj
1.0148 0 Td
(age)Tj
1.5421 0 Td
(or)Tj
1.0998 0 Td
(if)Tj
0.7767 0 Td
(they)Tj
1.9219 0 Td
(were)Tj
2.1259 0 Td
(in)Tj
1.0318 0 Td
(a)Tj
0.6577 0 Td
(Critical)Tj
-32.9837 -1.3039 Td
(Care)Tj
2.1089 0 Td
(environment.)Tj
5.6579 0 Td
(Participating)Tj
5.3688 0 Td
(hospitals)Tj
3.7417 0 Td
(were)Tj
2.1203 0 Td
(identified)Tj
4.0592 0 Td
(through)Tj
3.4469 0 Td
(local)Tj
2.075 0 Td
(collaborators)Tj
5.4368 0 Td
(via)Tj
1.3719 0 Td
(the)Tj
-35.3874 -1.2983 Td
(Welsh)Tj
2.7439 0 Td
(Intensive)Tj
3.8834 0 Td
(Care)Tj
2.1146 0 Td
(Society)Tj
3.0671 0 Td
(Audit)Tj
2.5285 0 Td
(and)Tj
1.7291 0 Td
(Research)Tj
3.8041 0 Td
(Group.)Tj
3.0841 0 Td
(The)Tj
1.7858 0 Td
(project)Tj
3.016 0 Td
(was)Tj
1.6951 0 Td
(approved)Tj
3.9742 0 Td
(by)Tj
1.1849 0 Td
(the)Tj
-34.6108 -1.2983 Td
(West)Tj
2.262 0 Td
(Midlands)Tj
4.0138 0 Td
(Regional)Tj
3.7304 0 Td
(Ethics)Tj
2.6589 0 Td
(Committee)Tj
4.7338 0 Td
(\(15/WM/0095\))Tj
6.2645 0 Td
(and)Tj
1.7235 0 Td
(patients)Tj
3.3618 0 Td
(gave)Tj
1.99 0 Td
(written)Tj
3.101 0 Td
(informed)Tj
-33.8397 -1.2982 Td
(consent.)Tj
3.5546 0 Td
(All)Tj
1.3946 0 Td
(demographic)Tj
5.5049 0 Td
(and)Tj
1.7291 0 Td
(clinical)Tj
3.0784 0 Td
(information)Tj
5.074 0 Td
(were)Tj
2.1259 0 Td
(de-identified)Tj
5.3575 0 Td
(as)Tj
1.0148 0 Td
(part)Tj
1.8425 0 Td
(of)Tj
1.0148 0 Td
(data)Tj
1.9162 0 Td
(collection)Tj
-33.6073 -1.3039 Td
(processes)Tj
3.9684 0 Td
(so)Tj
1.0885 0 Td
(that)Tj
1.7745 0 Td
(patient)Tj
3.0104 0 Td
(anonymity)Tj
4.5524 0 Td
(was)Tj
1.7008 0 Td
(strictly)Tj
2.9366 0 Td
(maintained)Tj
4.7906 0 Td
(throughout)Tj
4.7791 0 Td
(the)Tj
1.4684 0 Td
(study.)Tj
2.6135 0 Td
(The)Tj
1.7858 0 Td
(Size)Tj
1.7972 0 Td
(of)Tj
-36.2662 -1.2983 Td
(Sepsis)Tj
2.6248 0 Td
(in)Tj
1.0375 0 Td
(Wales)Tj
2.6475 0 Td
(project)Tj
3.0161 0 Td
(was)Tj
1.7008 0 Td
(registered)Tj
4.1498 0 Td
(with)Tj
2.0013 0 Td
(an)Tj
1.2019 0 Td
(international)Tj
5.4141 0 Td
(trial)Tj
1.8369 0 Td
(registry)Tj
3.2314 0 Td
(\(ISRCTN78293101\).)Tj
-27.6659 -1.2983 Td
(Local)Tj
2.3697 0 Td
(investigators)Tj
5.2781 0 Td
(were)Tj
2.1203 0 Td
(identified)Tj
4.0592 0 Td
(and)Tj
1.7348 0 Td
(were)Tj
2.1203 0 Td
(supported)Tj
4.2689 0 Td
(by)Tj
1.1849 0 Td
(three)Tj
2.262 0 Td
(national)Tj
3.5036 0 Td
(coordinators.)Tj
5.5729 0 Td
(Key)Tj
-35.6709 -1.3039 Td
(study)Tj
2.3867 0 Td
(information)Tj
5.0797 0 Td
(was)Tj
1.6951 0 Td
(provided)Tj
3.821 0 Td
(through)Tj
3.4413 0 Td
(e-mails,)Tj
3.3505 0 Td
(face-to-face)Tj
4.8642 0 Td
(training)Tj
3.4186 0 Td
(and)Tj
1.7291 0 Td
(online)Tj
2.7609 0 Td
(video)Tj
2.3981 0 Td
(tuto-)Tj
-34.9452 -1.2983 Td
(rials,)Tj
2.1259 0 Td
(which)Tj
2.6476 0 Td
(included)Tj
3.7133 0 Td
(the)Tj
1.4684 0 Td
(protocol,)Tj
3.821 0 Td
(answers)Tj
3.4073 0 Td
(to)Tj
1.0261 0 Td
(key)Tj
1.5931 0 Td
(questions)Tj
4.0195 0 Td
(and)Tj
1.7291 0 Td
(description)Tj
4.7338 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(electronic)Tj
-32.7682 -1.2982 Td
(case)Tj
1.8595 0 Td
(report)Tj
2.7099 0 Td
(form)Tj
2.2053 0 Td
(\(eCRF\).)Tj
3.3619 0 Td
(The)Tj
1.7801 0 Td
(details)Tj
2.778 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.474 0 Td
(digital)Tj
2.7212 0 Td
(data)Tj
1.9162 0 Td
(collection)Tj
4.1102 0 Td
(platform)Tj
3.702 0 Td
(developed)Tj
4.269 0 Td
(for)Tj
1.389 0 Td
(this)Tj
-35.2911 -1.3039 Td
(study)Tj
2.3867 0 Td
(have)Tj
2.0636 0 Td
(been)Tj
2.1203 0 Td
(published)Tj
4.1272 0 Td
(previously)Tj
4.3484 0 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
(].)Tj
2.0749 0 Td
(Medical)Tj
3.4356 0 Td
(students)Tj
3.5659 0 Td
(working)Tj
3.5603 0 Td
(in)Tj
1.0375 0 Td
(pairs)Tj
2.1713 0 Td
(to)Tj
1.0262 0 Td
(ensure)Tj
2.8743 0 Td
(data)Tj
-34.7922 -1.2983 Td
(validity)Tj
3.1634 0 Td
(and)Tj
1.7291 0 Td
(appropriate)Tj
4.8756 0 Td
(clinical)Tj
3.0727 0 Td
(knowledge,)Tj
4.7679 0 Td
(acted)Tj
2.3244 0 Td
(as)Tj
1.0091 0 Td
(data)Tj
1.9162 0 Td
(collectors,)Tj
4.2463 0 Td
(using)Tj
2.3867 0 Td
(tablets)Tj
2.7893 0 Td
(for)Tj
1.3833 0 Td
(electronic)Tj
-33.664 -1.2983 Td
(data)Tj
1.9105 0 Td
(collection)Tj
4.1102 0 Td
(and)Tj
1.7348 0 Td
(transfer.)Tj
3.5376 0 Td
(The)Tj
1.7858 0 Td
(tablets)Tj
2.7893 0 Td
(contained)Tj
4.1952 0 Td
(all)Tj
1.1452 0 Td
(supporting)Tj
4.6035 0 Td
(information)Tj
5.074 0 Td
(needed)Tj
3.0954 0 Td
(for)Tj
1.3889 0 Td
(the)Tj
-35.3704 -1.3039 Td
(study,)Tj
2.6135 0 Td
(including)Tj
4.0422 0 Td
(national)Tj
3.5036 0 Td
(formulary.)Tj
4.4673 0 Td
(Data)Tj
2.1203 0 Td
(collectors)Tj
4.0252 0 Td
(were)Tj
2.126 0 Td
(supported)Tj
4.2689 0 Td
(by)Tj
1.1849 0 Td
(continuous)Tj
4.7338 0 Td
(online)Tj
-33.0857 -1.2983 Td
(web-chat,)Tj
4.0932 0 Td
(which)Tj
2.6475 0 Td
(made)Tj
2.4264 0 Td
(the)Tj
1.4684 0 Td
(senior)Tj
2.6985 0 Td
(clinicians)Tj
4.0082 0 Td
(and)Tj
1.7291 0 Td
(the)Tj
1.4684 0 Td
(medical)Tj
3.3618 0 Td
(student)Tj
3.2088 0 Td
(national)Tj
3.5036 0 Td
(coordinators)Tj
-30.6139 -1.2982 Td
(available)Tj
3.668 0 Td
(throughout)Tj
4.7735 0 Td
(the)Tj
1.474 0 Td
(study)Tj
2.3867 0 Td
(period.)Tj
3.0614 0 Td
(Upon)Tj
2.5285 0 Td
(entry)Tj
2.3131 0 Td
(into)Tj
1.8425 0 Td
(the)Tj
1.4683 0 Td
(eCRF,)Tj
2.6816 0 Td
(each)Tj
2.0296 0 Td
(patient)Tj
3.0103 0 Td
(was)Tj
1.6952 0 Td
(assigned)Tj
3.6113 0 Td
(a)Tj
-36.544 -1.2983 Td
(unique)Tj
3.0217 0 Td
(study)Tj
2.3867 0 Td
(identifier.)Tj
4.1272 0 Td
(No)Tj
1.4627 0 Td
(patient)Tj
3.0104 0 Td
(identifiable)Tj
4.7168 0 Td
(data)Tj
1.9162 0 Td
(was)Tj
1.6951 0 Td
(submitted)Tj
4.252 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.4683 0 Td
(online)Tj
2.761 0 Td
(database.)Tj
3.8664 0 Td
(The)Tj
-35.7106 -1.3039 Td
(data)Tj
1.9105 0 Td
(collected)Tj
3.7417 0 Td
(were)Tj
2.1203 0 Td
(all)Tj
1.1509 0 Td
(part)Tj
1.8368 0 Td
(of)Tj
1.0148 0 Td
(routine)Tj
3.1634 0 Td
(clinical)Tj
3.0784 0 Td
(care.)Tj
2.0977 0 Td
(Patients)Tj
3.4072 0 Td
(were)Tj
2.126 0 Td
(followed)Tj
3.651 0 Td
(up)Tj
1.2642 0 Td
(until)Tj
2.109 0 Td
(90)Tj
1.1678 0 Td
(days)Tj
-33.8397 -1.2983 Td
(after)Tj
2.0352 0 Td
(study)Tj
2.3868 0 Td
(enrolment.)Tj
-3.2258 -1.2982 Td
(Data)Tj
2.1259 0 Td
(were)Tj
2.1203 0 Td
(collected)Tj
3.7417 0 Td
(for)Tj
1.3833 0 Td
(every)Tj
2.3471 0 Td
(patient,)Tj
3.2372 0 Td
(on)Tj
1.2755 0 Td
(whether)Tj
3.4753 0 Td
(their)Tj
2.109 0 Td
(management)Tj
5.4311 0 Td
(fulfilled)Tj
3.2825 0 Td
(the)Tj
1.4683 0 Td
(require-)Tj
-33.1934 -1.3039 Td
(ments)Tj
2.6702 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(Sepsis)Tj
2.6249 0 Td
(6)Tj
0.6973 0 Td
(bundle.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 217.0204 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Statistical)Tj
4.4504 0 Td
(analysis)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 200.0125 cm
BT
/F9 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Categorical)Tj
4.7508 0 Td
(variables)Tj
3.719 0 Td
(are)Tj
1.4513 0 Td
(described)Tj
4.0479 0 Td
(as)Tj
1.0148 0 Td
(proportions)Tj
4.9946 0 Td
(and)Tj
1.7291 0 Td
(are)Tj
1.4514 0 Td
(compared)Tj
4.2462 0 Td
(using)Tj
2.3868 0 Td
(chi-square)Tj
4.4107 0 Td
(or)Tj
1.0998 0 Td
(Fish-)Tj
-35.3024 -1.3039 Td
(er's)Tj
1.5873 0 Td
(exact)Tj
2.2677 0 Td
(test.)Tj
1.8255 0 Td
(Continuous)Tj
4.9777 0 Td
(variables)Tj
3.719 0 Td
(are)Tj
1.4456 0 Td
(described)Tj
4.0536 0 Td
(as)Tj
1.0148 0 Td
(mean)Tj
2.4434 0 Td
(and)Tj
1.7348 0 Td
(standard)Tj
3.719 0 Td
(deviation)Tj
3.9515 0 Td
(if)Tj
0.771 0 Td
(normally)Tj
-33.5109 -1.2982 Td
(distributed)Tj
4.5977 0 Td
(or)Tj
1.0942 0 Td
(median)Tj
3.2428 0 Td
(and)Tj
1.7291 0 Td
(inter-quartile)Tj
5.5559 0 Td
(range)Tj
2.4604 0 Td
(if)Tj
0.7767 0 Td
(not)Tj
1.5761 0 Td
(normally)Tj
3.8437 0 Td
(distributed.)Tj
4.8246 0 Td
(Comparisons)Tj
5.5785 0 Td
(of)Tj
-35.2797 -1.2983 Td
(continuous)Tj
4.7338 0 Td
(variables)Tj
3.719 0 Td
(are)Tj
1.4513 0 Td
(performed)Tj
4.4674 0 Td
(using)Tj
2.3924 0 Td
(one-way)Tj
3.617 0 Td
(ANOVA)Tj
3.7701 0 Td
(or)Tj
1.0941 0 Td
(Mann-Whitney)Tj
6.48 0 Td
(test)Tj
1.6044 0 Td
(as)Tj
1.0148 0 Td
(appro-)Tj
-34.3443 -1.2983 Td
(priate.)Tj
2.7552 0 Td
(To)Tj
1.338 0 Td
(assess)Tj
2.5228 0 Td
(the)Tj
1.4683 0 Td
(baseline)Tj
3.4299 0 Td
(factors)Tj
2.9027 0 Td
(associated)Tj
4.2576 0 Td
(with)Tj
1.9956 0 Td
(development)Tj
5.4141 0 Td
(of)Tj
1.0148 0 Td
(sepsis,)Tj
2.7326 0 Td
(a)Tj
0.6576 0 Td
(multi-variable)Tj
-30.4892 -1.3039 Td
(logistic)Tj
3.0557 0 Td
(regression)Tj
4.32 0 Td
(analysis)Tj
3.3221 0 Td
(was)Tj
1.7008 0 Td
(performed.)Tj
4.6942 0 Td
(Comorbidities,)Tj
6.2305 0 Td
(demographic)Tj
5.5048 0 Td
(and)Tj
1.7291 0 Td
(medication-)Tj
-30.5572 -1.2982 Td
(related)Tj
2.9366 0 Td
(variables)Tj
3.7077 0 Td
(were)Tj
2.1146 0 Td
(entered)Tj
3.2259 0 Td
(using)Tj
2.3867 0 Td
(forced)Tj
2.7496 0 Td
(simultaneous)Tj
5.5332 0 Td
(entry.)Tj
2.5342 0 Td
(A)Tj
0.8957 0 Td
(process)Tj
3.1748 0 Td
(of)Tj
1.0091 0 Td
(forward)Tj
3.3959 0 Td
(and)Tj
1.7178 0 Td
(back-)Tj
-35.3818 -1.2983 Td
(ward)Tj
2.2336 0 Td
(selection,)Tj
3.9458 0 Td
(based)Tj
2.4718 0 Td
(on)Tj
1.2756 0 Td
(minimisation)Tj
5.6239 0 Td
(of)Tj
1.0148 0 Td
(Akaike's)Tj
3.6 0 Td
(An)Tj
1.4513 0 Td
(Information)Tj
5.1534 0 Td
(Criterion)Tj
3.9344 0 Td
(\(AIC\),)Tj
2.812 0 Td
(was)Tj
1.7008 0 Td
(used)Tj
-35.2174 -1.3039 Td
(to)Tj
1.0261 0 Td
(derive)Tj
2.6872 0 Td
(the)Tj
1.4683 0 Td
(final)Tj
2.0013 0 Td
(model.)Tj
2.9707 0 Td
(Results)Tj
3.0614 0 Td
(are)Tj
1.4456 0 Td
(presented)Tj
4.1159 0 Td
(as)Tj
1.0148 0 Td
(odds)Tj
2.143 0 Td
(ratios)Tj
2.4605 0 Td
(with)Tj
1.9955 0 Td
(95%)Tj
1.9276 0 Td
(confidence)Tj
4.6034 0 Td
(intervals.)Tj
-32.9213 -1.2983 Td
(Significance)Tj
5.0513 0 Td
(is)Tj
0.8447 0 Td
(set)Tj
1.3039 0 Td
(at)Tj
0.9524 0 Td
(p)Tj
/F13 1 Tf
0 Tc
(<)Tj
/F9 1 Tf
-0.004 Tc
(0.05.)Tj
3.3903 0 Td
(A)Tj
0.9014 0 Td
(final)Tj
2.0012 0 Td
(analysis)Tj
3.3279 0 Td
(was)Tj
1.7007 0 Td
(performed)Tj
4.4674 0 Td
(at)Tj
0.9525 0 Td
(the)Tj
1.4683 0 Td
(end)Tj
1.7234 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(study.)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 229.8897 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Size)Tj
2.133 0 Td
(of)Tj
1.0347 0 Td
(Sepsis)Tj
3.1748 0 Td
(in)Tj
0.978 0 Td
(Wales:)Tj
3.2315 0 Td
(Point)Tj
2.4591 0 Td
(Prevalenc)Tj
4.3654 0 Td
(e)Tj
0.7653 0 Td
(Study)Tj
2.7426 0 Td
(on)Tj
1.311 0 Td
(the)Tj
1.5874 0 Td
(General)Tj
3.7134 0 Td
(Wards)Tj
3.0686 0 Td
(and)Tj
1.8567 0 Td
(Emergenc)Tj
4.4858 0 Td
(y)Tj
0.7158 0 Td
(Departments)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0167)Tj
3.5434 0 Td
(230)Tj
2.6362 0 Td
(December)Tj
4.7622 0 Td
(1,)Tj
1.0418 0 Td
(2016)Tj
37.2971 0 Td
(3)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
44 0 obj
<>stream
endstream
endobj
45 0 obj
<>stream
endstream
endobj
46 0 obj
<>stream
endstream
endobj
47 0 obj
<>stream
endstream
endobj
48 0 obj
<>stream
BT
66.402 0 Td
(12)Tj
ET
Q
endstream
endobj
49 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 51 0 R/Contents 52 0 R/TrimBox[0 0 612 792]>>
endobj
50 0 obj
<>stream
JFIF C
$, !$4.763.22:ASF:=N>22HbINVX]^]8EfmeZlS[]Y C**Y;2;YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY 4"
} !1AQa"q2#BR$3br
%&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz
w !1AQaq"2B #3Rbr
$4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ? (
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
(
g Ŕ
]FdK~?̟|/ [\zP?}ԏy'+`zʀ0?o[QHu .Q?* ƹvxgGj*.jB=GʺAI?* {6nɫ{~T`zʀ0nɩ?"ЏAQ?* ڽ5? *P?G?[P?G?[P֯{XGʷ|y}/[P?G[PdnϓV ` n]ϓRnʷ=F ` m^σTwcUF `nϓQu >M[ `l_Eؿ^L~=u *C]ϓVj-H(ڼR
˳чQ}U?*\A@#Zbj|(j|wcUF s['FQGʺAQ(ruoʏ˯z`z
ܺ 'ٽn}EtA@_,eگhj6#V*ʦʂ6㍷ |E (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((=* BWJǔ _7չX~ q z(h ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ))hIO5t_G'<9론iէPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPKP ) 5tZyO
q zk?V QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QE QI@ ';롮Om5xwC@SO(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((=* S jT@<) nV?ޭ Z(
(rlyW->j~(zZ LmA,d>SlӶi*9'eD y ڶ vdr$7WSNi RT3^[ۺ"3thz): Z*VaN]5\Z[S#d` (
(
(
(
(i7M IE27I