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• W4387249210 abstract "SESSION TITLE: Critical Care Posters 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Sepsis is an exaggerated response to infection with high morbidity and mortality. Current Surviving Sepsis Campaign Guidelines (SSC) recommend prompt antibiotics (Abx) within 1hour (hr) and 3 hr bundle compliance of suspected sepsis. We evaluated compliance with current SSC and the impact of incorporating a previously validated SeptiCyte RAPID assay in the initial evaluation of patients (pts) with suspected sepsis. METHODS: This was a retrospective, non-interventional evaluation of pts presenting to our tertiary center emergency department (ED) with suspected sepsis (> 2 signs of systemic inflammatory response syndrome, due to infection with organ dysfunction) from August 1- October 31, 2022. Pt demographics, sepsis indicators, first therapeutic Abx dose and SeptiCyte RAPID during sepsis workup was collected on each pt. Clinical probability of SIRS only vs Sepsis (Possible, Probable or Definite) was determined by investigators via chart review with defined criteria. Timing of Abx dosing and sepsis bundle completion were assessed from time of triage. SeptiCyte RAPID results are expressed as the SeptiScore® (range 0-15) and correlated with clinically defined sepsis probability. SeptiScore has been validated as distinct bands, of increasing sepsis probability - Band 1 = 10% to Band 4 = 81%. Statistical analysis used unpaired t-test or ANOVA. RESULTS: 62 total pts (32 SIRS/30 Sepsis), mean age (SD): 62.3 (21.1) yrs, 44.4% male, with mean SeptiScores SIRS 5.7 vs Sepsis 8.0 (P<0.0001). Sepsis clinical probability and SeptiScores were: SIRS (n=7) 4.0; Possible (n=16) 6.0; Probable (n=24) 6.7; Definite (n=15) 8.9 (p<0.01). Overall, 1 hr Abx compliance = 25.8%, 3 hr bundle compliance = 69.4%. SIRS pts compliance: 1 hr Abx = 14.3%; 3 hr bundle = 85.7%. Sepsis pts compliance: 1 hr Abx = 25% - 31.3%, 3 hr bundle = 56.3% - 68.8%. All SIRS pts were in Bands 1 or 2. Possible Sepsis pts were 62.5% Bands 1 or 2 vs 37.5% Bands 3 or 4. Probable Sepsis pts were 33.3% Bands 1 or 2 vs 66.7% Bands 3 or 4. All Definite Sepsis pts were in Bands 3 or 4. CONCLUSIONS: Abx administration and bundle compliance in suspected sepsis pts did not align with SSC. The SeptiScore provided actionable guidance during the initial clinical assessment of pts with suspected sepsis in the ED. In pts with possible or probable likelihood of sepsis, the SeptiScore can aid in Abx or diagnostic considerations based on sepsis likelihood. CLINICAL IMPLICATIONS: SeptiScore aligns with the low clinical probability group and should prompt the need to reconsider Abx use and look for other causes. In the high probability group, SeptiScore highlights the need to focus on Abx and bundle compliance. In the possible/probable probability group, SeptiScore discriminates the patients with a higher likelihood of sepsis. DISCLOSURES: No relevant relationships by Rakesh Alva No relevant relationships by Sadia Aslam Consultant relationship with Immunexpress Please note: 7/2020 - 2/2023 Added 04/13/2023 by Erkan Hassan, source=Web Response, value=Consulting fee" @default.
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• W4387249210 date "2023-10-01" @default.
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• W4387249210 title "POTENTIAL IMPACT OF A HOST RESPONSE GENE EXPRESSION SEPSIS ASSAY (SEPTICYTE RAPID) IN A TERTIARY EMERGENCY DEPARTMENT SETTING" @default.
• W4387249210 doi "https://doi.org/10.1016/j.chest.2023.07.1105" @default.
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