Abstract
Background
Few data are available on the validity of “Sepsis-3” criteria in identifying patients
with sepsis in internal medicine wards (IMWs). Real-life data about this topic and
on the prevalence of sepsis in IMWs could be useful for improving hospital organization.
Objectives
To assess the validity of "Sepsis-3" criteria in identifying patients with community-onset
sepsis in IMWs. Secondary objectives: to evaluate the prevalence of these patients
in IMWs and to compare "Sepsis-3" and "Sepsis-1" criteria.
Methods
Multicenter, prospective, observational, cohort study, carried out in 22 IMWs of Tuscany
(Italy). All patients admitted to each of the study centers over a period of 21-31
days were evaluated within 48 hours; those with clinical signs of infection were enrolled.
The main outcome was in-hospital mortality.
Results
2,839 patients were evaluated and 938 (33%) met the inclusion criteria. Patients with
sepsis diagnosed according to “Sepsis-3” were 522, representing 55.6% of patients
with infection and 18.4% of all patients hospitalized; they were older than those
without sepsis (79.4±12.5 vs 74.6±15.2 years, p<0.001). In-hospital mortality was
significantly higher in patients with sepsis compared to others (13.8% vs 4.6%; p<0.001).
“Sepsis-3” criteria showed greater predictive validity for in-hospital mortality than
“Sepsis-1” criteria (AUROC=0.71; 95%CI, 0.66-0.77 vs 0.60; 95%CI 0.54-0.66; p=0.0038).
Conclusions
"Sepsis-3" criteria are able to identify patients with community-onset sepsis in IMWs,
whose prevalence and in-hospital mortality are remarkably high. Medical departments
should adapt their organization to the needs for care of these complex patients.
Keywords
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Article info
Publication history
Published online: January 12, 2021
Accepted:
December 11,
2020
Received in revised form:
December 10,
2020
Received:
October 3,
2020
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
