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Size of sepsis in Wales: Feasibility pilot

Szakmany, Tamas, Ellis, Gemma, Lundin, Robert, Pignatelli, Llaria, Hall, Judith and Morgan, Paul 2014. Size of sepsis in Wales: Feasibility pilot. Critical Care Medicine 42 (12) , A1446. 10.1097/01.ccm.0000457854.38137.95

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Learning Objectives: The incidence of sepsis on the general wards is unknown in Wales, whilst sepsis accounts for 30% of all admissions to the ICUs. The introduction of the National Early Warning Score and the Sepsis Screening Tool makes it possible to estimate the true incidence. We performed a feasibility pilot study to estimate the incidence of sepsis and severe sepsis on the general wards. Methods: 1 day point prevalence study conducted in 4 hospitals (2 tertiary centres and 2 university affiliated general hospitals) on all general and obstetric wards using an anonymised pro-forma data collection sheet. Information was obtained by medical students who were trained in recognising the signs of sepsis. All patients with NEWS 3 or above were screened. Sepsis and severe sepsis was defined according to SSC criteria. Demographics, co-morbidities and significant drug therapy data was collected along with data on severity of sepsis, organ dysfunction and applied treatment. Results: 393 patients scored 3 or above on the NEWS. 16% of patients (n=62) had clinical signs of sepsis and 7.9% of patients (n=29) had severe sepsis with at least one organ dysfunction. Sepsis patients were similar age: 71 (61-84) years and NEWS 4 (3-6) compared to the non-sepsis patients. M/F ratio was 60/40. 23% of the patients had at least one significant co-morbidities. Out of the 62 sepsis patients only 4 had received the complete Sepsis 6 bundle. Critical Care input was obtained only in 5 patients with severe sepsis. Conclusions: The prevalence of sepsis and severe sepsis is high on the general wards and the problem is highly unrecognised. The lack of critical care referral of severe sepsis patients highlights the educational problem on ward level. Despite national effort, the delivery of the simple and effective Sepsis 6 treatment is lacking. The feasibility pilot showed that the research model employing the medical students as data collectors is workable and we are preparing to launch a nation-wide survey to get a true reflection about the size of the problem in different areas of the country.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Additional Information: Abstract
Publisher: Lippincott, Williams & Wilkins
ISSN: 0090-3493
Last Modified: 30 May 2019 15:28

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