Relationships and characteristics of patients with sepsis in the emergency department and 24-Hour mortality

Author

Marcia Spurgeon, University of Tennessee, KnoxvilleFollow

Date of Award

12-2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Sadie P. Hutson

Committee Members

Sadie P. Hutson, Tami H. Wyatt, Robert E. Heidel, Rebecca S. Koszalinski

Abstract

With at least 85% of global sepsis incidents occurring in resource-limited settings, the Surviving Sepsis Campaign aims to decrease worldwide sepsis morbidity and mortality through early diagnosis using widely available indicators. This sepsis incidence has created the need for research on early identification of patients at high risk of sepsis-associated mortality. The aim of this study was to identify easily accessible, rapidly measurable, and affordable biophysiological indicators associated with sepsis-related mortality within 24 hours of admission through the emergency department (ED). Since survivors and non-survivors of sepsis sequela present to the ED with similar characteristics, the researcher conducted a single-site, propensity-score matched, case-control, retrospective study at a medical center in southeast United States to identify patients at significant risk of early mortality after admission through the ED. Over a four-year period, the study site experienced a doubling of sepsis-associated mortality within 24 hours of admission through the ED. The researcher used baseline data from electronic health records of adult patients (N=228) consisting of cases (non-survivors at 24 hours after admission) (n₁=76), and controls (survivors beyond 24 hours of admission) (n₂=152). Findings from this study demonstrated patients' SOFA score (page (pplactate level (p 95% overall) of outcomes within 24 hours of admission with sepsis sequela. Identification of these indicators will assist clinicians in more efficient risk-stratification and escalation of care regardless of setting. Implications of these findings on nursing practice, nursing education, policy, and future research are presented.

Keywords: early sepsis mortality, sepsis sequela, biophysiological indicators, resource-limited settings, SOFA, lactate, age.

Recommended Citation

Spurgeon, Marcia, "Relationships and characteristics of patients with sepsis in the emergency department and 24-Hour mortality. " PhD diss., University of Tennessee, 2020.
https://trace.tennessee.edu/utk_graddiss/6189