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Recent Advances in Chest Medicine |

Identifying Patients with Sepsis on the Hospital Wards

Poushali Bhattacharjee, MD; Dana P. Edelson, MD, MS; Matthew M. Churpek, MD, MPH, PhD
Author and Funding Information

Conflicts of Interest/ Sources of Funding: Dr. Bhattacharjee is supported by a Postdoctoral Training Grant from the Agency for Healthcare Research and Quality (4T32HS000078). Dr. Churpek is supported by a career development award from the National Heart, Lung, and Blood Institute (K08 HL121080). Drs. Churpek and Edelson have a patent pending (ARCD. P0535US.P2) for risk stratification algorithms for hospitalized patients. In addition, Dr. Edelson has received research support and honoraria from Philips Healthcare (Andover, MA), research support from the American Heart Association (Dallas, TX) and Laerdal Medical (Stavanger, Norway), and an honorarium from Early Sense (Tel Aviv, Israel). She has ownership interest in Quant HC (Chicago, IL), which develops products for risk stratification of hospitalized patients.

Department of Medicine, University of Chicago, Chicago, IL

Corresponding author and requests for reprints (Matthew M Churpek) Mail: University of Chicago Medical Center, Section of Pulmonary and Critical Care Medicine, 5841 South Maryland Avenue MC 6076, Chicago, IL 60637.


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.06.020
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Abstract

Sepsis contributes to up to half of all deaths in hospitalized patients, and early interventions, such as appropriate antibiotics, have been shown to improve outcomes. Most research has focused on early identification and treatment of septic patients in the emergency department and the intensive care unit; however, many patients develop sepsis on the general wards. The goal of this review is to discuss recent advances in sepsis detection in patients on the hospital wards. It will discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening septic patients, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick Sepsis-related Organ Failure Assessment (qSOFA) score. Challenges specific to detecting sepsis on the wards will be discussed, and future directions that utilize big data approaches and automated alert systems will be highlighted.


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