INTRODUCTION: Our objectives were to calculate the timeliness of treatment following implementation of routine sepsis screening in an inpatient obstetric population using obstetric-adjusted systemic inflammatory response syndrome (SIRS) criteria, evaluate the performance of obstetric-specific screening criteria in the identification of sepsis, and to better characterize the frequency of end-organ dysfunction associated with those who met the definition of sepsis. METHODS: Electronic medical record data were collected from all pregnant or newly delivered women admitted for observation, admission, or postpartum readmission in the hospital maternity unit from March 1 through December 31, 2017 (n = 5075). Combinations of SIRS criteria were collected and compared with clinical indicators of end-organ dysfunction in those who met the definition of sepsis. Maternal conditions and neonatal outcomes were evaluated. RESULTS: In the study period, 204 cases of sepsis were identified among 201 women, 2 of whom experienced multiple episodes of sepsis, resulting in an incidence of sepsis of 4.0 per 100 livebirths. There were 92 (45.2%) with sepsis and 112 (54.9%) with end-organ dysfunction. Two women were admitted to the intensive care unit and no women died from sepsis. DISCUSSION: Use of a standardized, obstetric-specific sepsis screening process provided for early identification and treatment of sepsis in this population. Fourteen unique combinations of SIRS criteria were noted among those with sepsis; no combination was uniquely associated with the severity of sepsis. CONCLUSION: Pregnant and newly delivered women benefitted from implementation of routine sepsis screening; this resulted in timely initiation of treatment.
INTRODUCTION: Our objectives were to calculate the timeliness of treatment following implementation of routine sepsis screening in an inpatient obstetric population using obstetric-adjusted systemic inflammatory response syndrome (SIRS) criteria, evaluate the performance of obstetric-specific screening criteria in the identification of sepsis, and to better characterize the frequency of end-organ dysfunction associated with those who met the definition of sepsis. METHODS: Electronic medical record data were collected from all pregnant or newly delivered women admitted for observation, admission, or postpartum readmission in the hospital maternity unit from March 1 through December 31, 2017 (n = 5075). Combinations of SIRS criteria were collected and compared with clinical indicators of end-organ dysfunction in those who met the definition of sepsis. Maternal conditions and neonatal outcomes were evaluated. RESULTS: In the study period, 204 cases of sepsis were identified among 201 women, 2 of whom experienced multiple episodes of sepsis, resulting in an incidence of sepsis of 4.0 per 100 livebirths. There were 92 (45.2%) with sepsis and 112 (54.9%) with end-organ dysfunction. Two women were admitted to the intensive care unit and no women died from sepsis. DISCUSSION: Use of a standardized, obstetric-specific sepsis screening process provided for early identification and treatment of sepsis in this population. Fourteen unique combinations of SIRS criteria were noted among those with sepsis; no combination was uniquely associated with the severity of sepsis. CONCLUSION: Pregnant and newly delivered women benefitted from implementation of routine sepsis screening; this resulted in timely initiation of treatment.
Authors: Andrew Rhodes; Laura E Evans; Waleed Alhazzani; Mitchell M Levy; Massimo Antonelli; Ricard Ferrer; Anand Kumar; Jonathan E Sevransky; Charles L Sprung; Mark E Nunnally; Bram Rochwerg; Gordon D Rubenfeld; Derek C Angus; Djillali Annane; Richard J Beale; Geoffrey J Bellinghan; Gordon R Bernard; Jean-Daniel Chiche; Craig Coopersmith; Daniel P De Backer; Craig J French; Seitaro Fujishima; Herwig Gerlach; Jorge Luis Hidalgo; Steven M Hollenberg; Alan E Jones; Dilip R Karnad; Ruth M Kleinpell; Younsuk Koh; Thiago Costa Lisboa; Flavia R Machado; John J Marini; John C Marshall; John E Mazuski; Lauralyn A McIntyre; Anthony S McLean; Sangeeta Mehta; Rui P Moreno; John Myburgh; Paolo Navalesi; Osamu Nishida; Tiffany M Osborn; Anders Perner; Colleen M Plunkett; Marco Ranieri; Christa A Schorr; Maureen A Seckel; Christopher W Seymour; Lisa Shieh; Khalid A Shukri; Steven Q Simpson; Mervyn Singer; B Taylor Thompson; Sean R Townsend; Thomas Van der Poll; Jean-Louis Vincent; W Joost Wiersinga; Janice L Zimmerman; R Phillip Dellinger Journal: Intensive Care Med Date: 2017-01-18 Impact factor: 17.440
Authors: Melissa E Bauer; Samuel T Bauer; Baskar Rajala; Mark P MacEachern; Linda S Polley; David Childers; David M Aronoff Journal: Obstet Gynecol Date: 2014-09 Impact factor: 7.661