Clinical Characteristics and Outcomes of Sepsis in Adult Patients Admitted Through the Emergency Department: A Prospective Observational Study.: Original Article

Hayat Muhammad Khan; Jehan Hussan; Jalwa Nargis

doi:10.64911/2z005v58

Authors

Hayat Muhammad Khan Associate Professor, Community Medicine Department, Khyber Medical College, Peshawar Author https://orcid.org/0009-0005-3707-8199
Jehan Hussan Assistant Professor, Community Medicine, KMC Peshawar Author https://orcid.org/0009-0008-9805-4934
Jalwa Nargis WMO FCPS Obs/Gynae Peshawar Author

DOI:

https://doi.org/10.64911/2z005v58

Keywords:

Sepsis; Emergency department; SOFA score; Mortality

Abstract

Background: Sepsis is a life- threatening syndrome characterized by an abnormal host response to infection and is a significant cause of morbidity and mortality worldwide. Early recognition and intervention in the emergency department (ED) are vital. This research compared clinical parameters and outcomes at presentation among adult patients with sepsis presenting to the ED.

Objectives: To determine the demographic characteristics, clinical presentation, sources of infection, management strategies, and hospital outcomes among adult patients presenting with sepsis to the ED, and to identify clinical factors associated with in- hospital mortality.

Methods: This prospective observational study of 8 months' duration included 100 adult patients with a Sepsis- 3 diagnosis in the ED of a tertiary care hospital. Collected data included demographic information, comorbidities, clinical and laboratory parameters, SOFA scores, source of infection, treatment measures, and hospital outcomes. All data were analyzed using SPSS version 27. 0. Continuous data were presented as mean ± SD, categorical data as frequencies and percentages, and a p- value < 0. 05 was considered significant.

Results: Of the 100 patients, 61% were male, with a mean age of 59. 4 ± 15. 8 years. Pneumonia (38%) and urinary tract infection (27%) were the leading infection sources. The mean SOFA score was 7. 7.2 ± 2. 2.6. ICU admission and mechanical ventilation were required in 32% and 24% of patients, respectively, while septic shock occurred in 26%. In- hospital mortality was 18%. Non- survivors had significantly higher serum lactate levels (4. 4.5 ± 1. 1.6 vs. 2. 2.8 ± 1. 2 mmol/L; p = 0. 002) and SOFA scores (9. 3 ± 2. 2.4 vs. 6. 6 ± 2. 1; p< 0. 001). Delayed antibiotic administration beyond one hour was associated with increased mortality (p = 0. 018).

Conclusion: Significant morbidity and mortality were observed among adult patients with sepsis admitted to the ED. Results indicated that higher SOFA scores, higher serum lactate levels, and later antibiotic treatment were associated with lower survival, suggesting that early diagnosis, early antibiotic treatment, and active supportive care were important.