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Internal Medicine

Early recognition of sepsis remains challenging in older hospitalized patients

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There are still many challenges in recognizing sepsis early and implementing care bundles in older inpatients, leading experts to suggest additional educational programs are needed for nurses and medical staff, as well as closer patient monitoring.

The medical records of confirmed or probable sepsis cases were included in this retrospective study. After the first digitally generated alert of clinical deterioration, investigations and treatments were compared with a best-practice sepsis care bundle.

Overall, there were 169 screened care episodes, of which 59 were probable or confirmed cases of sepsis.

Of the 59 cases, 72.9% did not mention sepsis in the differential diagnosis on the first medical review. Only 64% of cases were managed as having sepsis and only about 30% of cases had care bundle components, including blood cultures, serum lactate, and intravenous fluid resuscitation, and antibiotics, delivered. In 73.7% of cases antibiotic administration was delayed more than an hour.

“Education programs in sepsis care standards targeting nurses and junior medical staff, closer patient monitoring, and post-discharge follow-up may improve patient outcomes,” the authors concluded.

Reference

Barker N, Scott IA, Seaton R, et al. Recognition and Management of Hospital-Acquired Sepsis Among Older General Medical Inpatients: A Multi-Site Retrospective Study. Int J Gen Med. 2023;16:1039-1046. doi: 10.2147/IJGM.S400839. PMID: 36987405; PMCID: PMC10039973.

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