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Tytuł pozycji:

Sepsis scoring systems and use of the Sepsis six care bundle in maternity hospitals

Tytuł:
Sepsis scoring systems and use of the Sepsis six care bundle in maternity hospitals
Autorzy:
Nouf Abutheraa
June Grant
Alexander B. Mullen
Temat:
Sepsis
Sepsis scoring systems
Sepsis diagnosis
Obstetric
Maternity
Systemic inflammatory response syndrome
Gynecology and obstetrics
RG1-991
Źródło:
BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-7 (2021)
Wydawca:
BMC, 2021.
Rok publikacji:
2021
Kolekcja:
LCC:Gynecology and obstetrics
Typ dokumentu:
article
Opis pliku:
electronic resource
Język:
English
ISSN:
1471-2393
Relacje:
https://doaj.org/toc/1471-2393
DOI:
10.1186/s12884-021-03921-3
Dostęp URL:
https://doaj.org/article/4c0652bcdc924cafac42d5be04ad3a00  Link otwiera się w nowym oknie
Numer akcesji:
edsdoj.4c0652bcdc924cafac42d5be04ad3a00
Czasopismo naukowe
Abstract Background This study aimed to assess the predictive power of three different Sepsis Scoring Systems (SSSs), namely maternity Systematic Inflammatory Response Syndrome (mSIRS), quick Sepsis-related Organ Failure Assessment (qSOFA) and Modified Early Warning System (MEWS) in identifying sepsis by comparing them with positive culture. This study also sought to evaluate compliance with using the Sepsis Six Care Bundle (SSCB) operated in an individual health board. Methods A retrospective cohort study was conducted in 3 maternity hospitals of a single Scottish health board that admitted 2690 pregnancies in a 12 weeks period in 2016. Data for study was obtained from medical notes, handheld and electronic health records for women who were prescribed antibiotics with a confirmed or suspected diagnosis of sepsis. Data on clinical parameters was used to classify women according to mSIRS, qSOFA and MEWS as having sepsis or not and this was compared to results of positive culture to obtain sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under Receiver Operating Characteristic curve (AUROC) along with their 95% confidence intervals. Data was also obtained on SSCB compliance. Results A total of 89 women were diagnosed with sepsis, of which 14 had missing data, leaving 75 for final analysis. Sensitivity, specificity, PPV, NPV and AUROC of mSIRS and MEWS were almost similar with AUROC of both being around 50%. Only 33 (37.1%) had identifiable sepsis six sticker displayed on medical notes and only 2 (2.2%) had all elements of SSCB delivered within the recommended one-hour post-diagnosis period. Blood culture and full blood count with other lab tests had been performed for most women (97%) followed by intravenous antibiotics and fluids (93.9%). Conclusions mSIRS and MEWS were quite similar in detecting sepsis when compared to positive culture, with their ability to detect sepsis being close to chance. This underlines the need for creating a valid SSS with high sensitivity and specificity for clinical use in obstetric settings. Clinical use of SSCB was limited despite it being a health board policy, although there is considerable possibility of improvement following detailed audits and removal of barriers for implementing SSCB.

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