Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study
<b>Background/Objectives</b>: Sepsis is one of the most common causes of death worldwide, and its diagnosis remains a challenge for clinicians. The main purpose of this study was to appraise the diagnosis and antibiotic prescription pattern for sepsis admitted to the Emergency Department...
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MDPI AG
2025-06-01
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| Online Access: | https://www.mdpi.com/2227-9059/13/7/1566 |
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| author | Eszter Varga Sándor Somodi Máté Molnár Dóra Ujvárosy Krisztina Gaál Attila Vaskó Zoltán Szabó Ildikó Bácskay István Lekli Adina Fésüs |
| author_facet | Eszter Varga Sándor Somodi Máté Molnár Dóra Ujvárosy Krisztina Gaál Attila Vaskó Zoltán Szabó Ildikó Bácskay István Lekli Adina Fésüs |
| author_sort | Eszter Varga |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Sepsis is one of the most common causes of death worldwide, and its diagnosis remains a challenge for clinicians. The main purpose of this study was to appraise the diagnosis and antibiotic prescription pattern for sepsis admitted to the Emergency Department (ED), comparing Sepsis-2 to Sepsis-3 criteria. <b>Methods</b>: The study was conducted in an ED of a tertiary care medical center in Hungary. We included all adult patients who were diagnosed with sepsis in 2023. Data collection was made manually from UD MED System. Diagnosis was assessed based on Sepsis-2 and Sepsis-3 criteria, then compared. Further analyses were made only in cases with confirmed sepsis diagnosis. Antibiotic guideline adherence was determined according to the local guideline in force. Fisher’s exact test, <i>t</i>-test, and ANOVA were applied to compare categorical and continuous variables between groups. The Kaplan–Meier test was applied for probability of survival. Significant <i>p</i>-values were defined as below 0.05. <b>Results</b>: The substantial majority of patients recorded with sepsis in the ED met both the Sepsis-2 and Sepsis-3 criteria (80%), while the rate of misdiagnosis was similar (Sepsis-2: 16/91, 17.6% and Sepsis-3: 14/91, 15.4%). The most important identified risk factors in sepsis were old age (60+ years) and comorbidities (CCI ≥ 4). Elevated LDH (median 325 mg/dL) and decreased albumin levels (median 26 g/L) can be used as early indicators of sepsis. Although the time to first antibiotic administration was not associated with significantly better clinical outcomes, the guideline-adherent agent selection (Sepsis-2: 18/43, 41.9% and Sepsis-3: 19/46: 41.3%) led to a significantly longer survival (median 37 vs. 4 days). <b>Conclusions</b>: No significant differences were found in diagnostic accuracy or prediction of mortality between Sepsis-2 and Sepsis-3. Guideline-adherent antibiotics may lead to significantly higher survival rate in sepsis. |
| format | Article |
| id | doaj-art-9d5d4bfe03b944e7b3056c440b14c796 |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-9d5d4bfe03b944e7b3056c440b14c7962025-08-20T03:36:02ZengMDPI AGBiomedicines2227-90592025-06-01137156610.3390/biomedicines13071566Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational StudyEszter Varga0Sándor Somodi1Máté Molnár2Dóra Ujvárosy3Krisztina Gaál4Attila Vaskó5Zoltán Szabó6Ildikó Bácskay7István Lekli8Adina Fésüs9Doctoral School of Pharmaceutical Sciences, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Emergency Care and Oxyology, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Pharmacodynamics, Faculty of Pharmacy, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Emergency Care and Oxyology, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Pulmonology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Emergency Care and Oxyology, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Pharmacodynamics, Faculty of Pharmacy, University of Debrecen, H-4032 Debrecen, HungaryDepartment of Pharmacodynamics, Faculty of Pharmacy, University of Debrecen, H-4032 Debrecen, Hungary<b>Background/Objectives</b>: Sepsis is one of the most common causes of death worldwide, and its diagnosis remains a challenge for clinicians. The main purpose of this study was to appraise the diagnosis and antibiotic prescription pattern for sepsis admitted to the Emergency Department (ED), comparing Sepsis-2 to Sepsis-3 criteria. <b>Methods</b>: The study was conducted in an ED of a tertiary care medical center in Hungary. We included all adult patients who were diagnosed with sepsis in 2023. Data collection was made manually from UD MED System. Diagnosis was assessed based on Sepsis-2 and Sepsis-3 criteria, then compared. Further analyses were made only in cases with confirmed sepsis diagnosis. Antibiotic guideline adherence was determined according to the local guideline in force. Fisher’s exact test, <i>t</i>-test, and ANOVA were applied to compare categorical and continuous variables between groups. The Kaplan–Meier test was applied for probability of survival. Significant <i>p</i>-values were defined as below 0.05. <b>Results</b>: The substantial majority of patients recorded with sepsis in the ED met both the Sepsis-2 and Sepsis-3 criteria (80%), while the rate of misdiagnosis was similar (Sepsis-2: 16/91, 17.6% and Sepsis-3: 14/91, 15.4%). The most important identified risk factors in sepsis were old age (60+ years) and comorbidities (CCI ≥ 4). Elevated LDH (median 325 mg/dL) and decreased albumin levels (median 26 g/L) can be used as early indicators of sepsis. Although the time to first antibiotic administration was not associated with significantly better clinical outcomes, the guideline-adherent agent selection (Sepsis-2: 18/43, 41.9% and Sepsis-3: 19/46: 41.3%) led to a significantly longer survival (median 37 vs. 4 days). <b>Conclusions</b>: No significant differences were found in diagnostic accuracy or prediction of mortality between Sepsis-2 and Sepsis-3. Guideline-adherent antibiotics may lead to significantly higher survival rate in sepsis.https://www.mdpi.com/2227-9059/13/7/1566albumin levelantibioticguideline adherentlength of stayrisk factorssepsis |
| spellingShingle | Eszter Varga Sándor Somodi Máté Molnár Dóra Ujvárosy Krisztina Gaál Attila Vaskó Zoltán Szabó Ildikó Bácskay István Lekli Adina Fésüs Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study Biomedicines albumin level antibiotic guideline adherent length of stay risk factors sepsis |
| title | Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study |
| title_full | Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study |
| title_fullStr | Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study |
| title_full_unstemmed | Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study |
| title_short | Evaluation of the Diagnosis and Antibiotic Therapy of Sepsis in the Emergency Department: A Retrospective Observational Study |
| title_sort | evaluation of the diagnosis and antibiotic therapy of sepsis in the emergency department a retrospective observational study |
| topic | albumin level antibiotic guideline adherent length of stay risk factors sepsis |
| url | https://www.mdpi.com/2227-9059/13/7/1566 |
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