Predicting sepsis at emergency department triage: Implementing clinical and laboratory markers within the first nursing assessment to enhance diagnostic accuracy

Background Early identification of sepsis in the emergency department (ED) triage is both valuable and challenging. Numerous studies have endeavored to pinpoint clinical and biochemical criteria to assist clinicians in the prompt diagnosis of sepsis, but few studies have assessed the efficacy of the...

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Bibliographic Details
Published in:Journal of nursing scholarship 2024-11, Vol.56 (6), p.757-766
Main Authors: Sisto, Ugo Giulio, Di Bella, Stefano, Porta, Elisa, Franzoi, Giorgia, Cominotto, Franco, Guzzardi, Elena, Artusi, Nicola, Giudice, Caterina Anna, Dal Bo, Eugenia, Collot, Nicholas, Sirianni, Francesca, Russo, Savino, Sanson, Gianfranco
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - blood
C-Reactive Protein - analysis
CRP/albumin ratio
emergency department triage
Emergency Service, Hospital - statistics & numerical data
eosinophil count
Female
Humans
Male
mean arterial pressure
Middle Aged
Nursing Assessment - methods
PetCO2
procalcitonin
Procalcitonin - blood
Prospective Studies
sepsis
Sepsis - blood
Sepsis - diagnosis
Triage - methods
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Summary:Background Early identification of sepsis in the emergency department (ED) triage is both valuable and challenging. Numerous studies have endeavored to pinpoint clinical and biochemical criteria to assist clinicians in the prompt diagnosis of sepsis, but few studies have assessed the efficacy of these criteria in the ED triage setting. The aim of the study was to explore the accuracy of clinical and laboratory markers evaluated at the triage level in identifying patients with sepsis. Methods A prospective study was conducted in a large academic urban hospital, implementing a triage protocol aimed at early identification of septic patients based on clinical and laboratory markers. A multidisciplinary panel of experts reviewed cases to ensure accurate identification of septic patients. Variables analyzed included: Charlson comorbidity index, mean arterial pressure (MAP), partial pressure of carbon dioxide (PetCO2), white cell count, eosinophil count, C‐reactive protein to albumin ratio, procalcitonin, and lactate. Results A total of 235 patients were included. Multivariable analysis identified procalcitonin ≥1 ng/mL (OR 5.2; p 
ISSN:1527-6546
1547-5069
1547-5069
DOI:10.1111/jnu.13002