Researchers have identified the specific symptoms that put patients at the greatest risk of dying from sepsis - and they're not what many clinicians might think.

The data offers an advanced analytical model for detecting early warning signs of sepsis and for differentiating between different organ dysfunctions' contribution to in-hospital morality. "We now have large-scale evidence that many of these organ system failures that are typically underappreciated - particularly the renal and respiratory systems - actually have the highest association with death," said study co-principal investigator Ryan Arnold, MD, an emergency medicine doctor and faculty member at Drexel College of Medicine. "That means that symptoms related to these systems need to be raising a red flag for doctors. We're saying, 'Hey, this is the type of patient you need to be paying more attention to.'"
The researchers found that the more well-known symptoms of sepsis, such as low blood pressure, were linked to lower mortality rates in the population they studied.
"That likely speaks more to the health care providers' response to the symptom, than the low blood pressure itself actually being a protective factor," Arnold added. "With sepsis, patients generally don't fall off of a cliff. Instead, it's a day by day, gradual deterioration. Maybe someone has a small increase in creatinine today, and tomorrow it's a little worse. Those subtle changes that don't get detected, we found, lead to death."
To quantify the association between organ dysfunctions and health outcomes, the research team used retrospective Electronic Health Record data for adult patients hospitalized within Delaware's Christiana Care Health System from July 2013 to April 2016. They analyzed the relationship between in-hospital mortality and symptoms with seven organ systems: cardiovascular, metabolic, hematopoietic, nervous, gastrointestinal, renal and respiratory.
Of the 210,289 visits during the study period, 62,057 patients (30 percent) were treated for an infection, and 48,680 (78 percent) experienced organ dysfunction. Of the patients treated for an infection, 1,955 (3 percent) died during this period. Patients with worsening kidney function (increase in creatinine levels by 50 percent from baseline) had the highest mortality rate (17 percent), followed by mechanical ventilation requirement (13 percent). Patients with hypotension had the lowest incidents of death. The researchers also found that treating patients for an infection within 24 hours of being admitted to the hospital significantly lowered their risk of dying.
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"The integration of analytics and clinical, translational research provides insight into developing smart and connected systems that support data-driven and personalized management of sepsis," Capan said.
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"Now, when a new patient walks into the hospital, we can use our math and analytic skills to match that patient's fingerprint and really see: 'What is that person's individualized risk of in-hospital death?' and 'What is that person's individual risk of developing septic shock?' That is very useful, and very exciting," Capan said.
Source-Eurekalert