Impact of the diagnostic process on the accuracy of source identification and time to antibiotics in septic emergency department patients.

Objective: Timely administration of effective antibiotics is important in sepsis management. Source-targeted antibiotics are believed to be most effective, but source identification could cause time delays.

Objectives: First, to describe the accuracy/time delays of a diagnostic work-up and the association with time to antibiotics in septic emergency department (ED) patients.

Lack of clinically evident signs of organ failure affects ED treatment of patients with severe sepsis.

Background: It is not known whether lack of recognition of organ failure explains the low compliance with the "Surviving Sepsis Campaign" (SSC) guidelines. We evaluated whether compliance was higher in emergency department (ED) sepsis patients with clinically recognizable signs of organ failure compared to patients with only laboratory signs of organ failure.

Methods: Three hundred twenty-three ED patients with severe sepsis and septic shock were prospectively included.

The prognostic performance of the predisposition, infection, response and organ failure (PIRO) classification in high-risk and low-risk emergency department sepsis populations: comparison with clinical judgement and sepsis category.

Objective: To compare the prognostic performance of the predisposition, infection, response and organ failure (PIRO) score with the traditional sepsis category and clinical judgement in high-risk and low-risk Dutch emergency department (ED) sepsis populations.

Methods: Prospective study in ED patients with severe sepsis and septic shock (high-risk cohort), or suspected infection (low-risk cohort).

Outcome: 28-day mortality.

Performance of illness severity scores to guide disposition of emergency department patients with severe sepsis or septic shock.

Objective: To determine the number of emergency department (ED) patients with severe sepsis who are admitted to the ICU and to assess whether the predisposition, infection, response and organ failure (PIRO) score can be used as a clinical decision-making tool for guiding the disposition of ED sepsis patients to wards or the ICU.

Methods: This is a prospective study including ED patients with severe sepsis and septic shock. The PIRO score and in-hospital mortality were assessed in patients admitted to wards and ICUs.