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：

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败血症患者的院前特征：有或没有不良结局的患者之间的比较。

背景技术败血症患者的院前护理通常由紧急医疗服务进行。这些患者可能是重症患者，住院死亡率很高。不幸的是，紧急医疗服务很少识别出败血症患者，这可能导致治疗延误和预后恶化。因此，败血症患者的早期识别很重要，并且需要有关可用于识别这些患者的院前特征的更多信息。基于这种缺乏的信息，本研究的目的是调查在脓毒症患者被紧急医疗服务机构运送到医院时识别出的院前特征，并将这些值与住院期间有或没有不良后果的患者的值进行比较。方法这是一项回顾性观察研究。对患者的电子健康记录进行了审查，并根据以下条件进行了选择：回顾性诊断为败血症，并由急诊医疗机构运送到急诊科。收集有关人口统计学，院前特征和不良结局（定义为重症监护病房的院内死亡率或治疗）的数据，并通过独立样本t检验和卡方检验进行分析。分析了院前特征对不良结局的预测或发展的敏感性，特异性和似然比。结果总共包括327例患者。其中，50例患者有不良预后。当比较有或没有不良结果的患者时，发现氧饱和度和体温降低，住院前护理期间血清葡萄糖水平升高和精神状态改变与不良结果有关。结论研究结果表明，在院前护理期间血氧饱和度和体温降低，血糖水平升高和精神状态改变的患者存在患者预后较差和不良后果的风险。认识这些院前特征可能有助于及早发现败血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清葡萄糖的极限值，并验证败血症患者不良后果的院前特征的使用。