Background: In sepsis, every hour of delay in antibiotic administration after the onset of hypotension is associated with 4-7% increase in mortality, but little is known about the characteristics of patients with treatment delays. Our objective was to determine if septic adults presenting to the Emergency Department (ED) who receive antibiotics more than 60 minutes [...]

Background: Third International Consensus Definitions for Sepsis and Septic Shock (SEP-3) defines Sepsis as life-threatening organ dysfunction due to a dysregulated host response to infection. In United States about 1.5 million Americans are diagnosed with Sepsis each year and about 250,000 of them die each year. It is also the costliest single diagnosis to treat [...]

Background: Standard risk prediction tools including the quick-Sequential Organ Failure Assessment (qSOFA) have been validated using in-hospital outcomes (mortality [Died-Hosp] or intensive care unit stay >72 hours [ICU72]). Yet, risk models are often applied to predict outcomes beyond hospitalization, and it is unclear what effect outcome selection has on model performance. We derived independent robust [...]

Background: Delays in antibiotic administration in sepsis – particularly after the development of hypotension – are associated with increased mortality. Current guidelines recommend antibiotic initiation within one hour of sepsis recognition. However, it is not known how timing of hypotension relates to the timing of meeting sepsis diagnostic criteria and the initiation of treatment. We [...]

Background: Depending on the criterion applied, the systemic inflammatory response syndrome (SIRS) criteria and the Sequential Organ Failure Assessment (SOFA) criteria initially identify distinct populations that present to the emergency department (ED) with suspected sepsis (Prasad et al., SHM 2018). Our work has shown that 52% of patients meet SIRS criteria first and 48% meet [...]

Background: Sepsis is a significant cause of morbidity and mortality in hospitalized patients . Early and appropriate therapy has been shown to improve outcomes, making early diagnosis and intervention critical . However, recognition and treatment of sepsis remains a challenge . In order to understand how to best deliver sepsis treatment in different hospitals within [...]

Background: Sepsis is a leading cause of death in US hospitals, and is a major contributor to hospital mortality and length of stay. Much has been done in hospitals nationwide to identify and treat sepsis early. Similarly, at Bridgeport Hospital, a clinical redesign was initiated to identify and act on patients with signs of sepsis [...]

Background: Best-Practice Alerts (BPAs), utilized to reduce the number of adverse events in medical settings, have limited efficacy partly due to alert fatigue and user desensitization. Alert fatigue often stems from inaccurate alerts firing too often as well as poor physician perception of the efficacy of the alerts, both of which lead to reduced physician [...]

Background: The Children’s Hospital Association (CHA) Sepsis Collaborative recognizes pediatric sepsis as a significant cause of mortality and nationwide efforts are being developed to improve sepsis recognition. A critical component to decreasing sepsis mortality is early identification of sepsis so that interventions are initiated quickly. At Johns Hopkins All Children’s Hospital, there is a significant [...]

Background: The annual incidence of sepsis is about 1.7 million in the United States and about 270,000 Americans die as a result of sepsis each year. Atrial fibrillation is the most common arrhythmia seen in hospitalized patients and has shown to unfavorably alter the cardiovascular hemodynamics in patients admitted with sepsis. However there are only [...]