BACKGROUND The prehospital care of patients with sepsis are commonly performed by the emergency medical services. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients with sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse prognosis. Therefore, early identification of patients with sepsis is important, and more information about the prehospital characteristics that can be used to identify these patients is needed. Based on this lack of information, the objectives of this study were to investigate the prehospital characteristics that are identified while patients with sepsis are being transported to the hospital by the emergency medical services, and to compare these values to those of the patients with and without adverse outcomes during their hospital stays. METHODS This was a retrospective observational study. The patients' electronic health records were reviewed and selected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an emergency department by the emergency medical services. Data were collected on demographics, prehospital characteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit, and analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital characteristics for predicting or development of adverse outcome were analysed. RESULTS In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing patients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care were found to be associated with an adverse outcome. CONCLUSIONS The findings suggests that patients having a decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient prognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with sepsis early and improve their long-term outcomes. However further research is required to predict limit values of saturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients with sepsis.

中文翻译：

---

脓毒症患者的院前特征：有或没有不良结果的患者之间的比较。


背景技术脓毒症患者的院前护理通常由紧急医疗服务机构进行。这些患者可能病情危重，院内死亡率很高。不幸的是，紧急医疗服务机构很少发现脓毒症患者，这可能导致治疗延迟和预后较差。因此，早期识别败血症患者非常重要，并且需要更多有关可用于识别这些患者的院前特征的信息。基于信息的缺乏，本研究的目的是调查在紧急医疗服务将脓毒症患者送往医院时识别出的院前特征，并将这些值与脓毒症患者和非脓毒症患者的值进行比较。住院期间的不良后果。方法 这是一项回顾性观察研究。根据以下条件连续审查和选择患者的电子健康记录：回顾性诊断为脓毒症并由紧急医疗服务部门转运至急诊科。收集人口统计数据、院前特征和不良结局（定义为院内死亡率或重症监护室治疗）数据，并通过独立样本 t 检验和卡方进行分析。分析了院前特征预测不良结果或发生的敏感性、特异性和似然比。结果 总共纳入 327 名患者。其中，50 名患者出现不良后果。 当比较有或没有不良结果的患者时，发现血氧饱和度和体温降低、血糖水平升高以及院前护理期间精神状态改变与不良结果相关。结论 研究结果表明，院前护理期间血氧饱和度和体温降低、血糖水平升高以及精神状态改变的患者面临患者预后较差和不良结果的风险。认识这些院前特征可能有助于及早识别脓毒症患者并改善其长期预后。然而，需要进一步的研究来预测饱和度和血糖的极限值，并验证院前特征对脓毒症患者不良结局的应用。