Noah's Ark Children's Hospital for Wales, Cardiff, UK.
Cardiff University, Cardiff, UK.
Acta Paediatr. 2022 Dec;111(12):2262-2277. doi: 10.1111/apa.16536. Epub 2022 Sep 14.
Sepsis is an acute illness associated with significant morbidity and mortality. Early detection and time-sensitive management of sepsis has been shown to improve outcomes. We report the results of a scoping review to explore methods evaluated for the identification of sepsis in children presenting to emergency departments.
A systematic literature search was carried out on two databases, Medline and Web of Science, to identify relevant studies published from 1990 to 2022. Data were extracted for age groups including study design, reference standard used for comparison, sepsis identification method evaluated and study quality.
A total of 89 studies were identified from the literature search. There was significant heterogeneity in the age groups including study design and reference standards used for evaluating the performance of the sepsis identification methods. There has been a substantial increase in the number of published studies in the last 2 years.
Our scoping review identifies marked heterogeneity in approaches to identifying sepsis but demonstrates a recent focus of research on patient outcomes. Using appropriate core outcome sets, developing reference standards, monitoring sepsis prevalence via registries and continuously monitoring process measures will provide robust evidence to identify the best performing identification tools and the impact they have on patient-orientated outcomes.
脓毒症是一种与高发病率和死亡率相关的急性疾病。早期发现和及时处理脓毒症已被证明可以改善预后。我们报告了一项范围综述的结果，以探讨在急诊科就诊的儿童中用于识别脓毒症的方法。
我们在两个数据库（Medline 和 Web of Science）上进行了系统的文献检索，以确定从 1990 年到 2022 年发表的相关研究。我们提取了包括研究设计、用于比较的参考标准、评估的脓毒症识别方法和研究质量在内的数据。
从文献检索中总共确定了 89 项研究。在包括研究设计和用于评估脓毒症识别方法性能的参考标准在内的年龄组方面，存在显著的异质性。在过去的 2 年中，发表的研究数量显著增加。
我们的范围综述确定了识别脓毒症的方法存在明显的异质性，但表明最近的研究重点是患者结局。使用适当的核心结局集、制定参考标准、通过登记处监测脓毒症的患病率以及持续监测流程措施，将为识别性能最佳的识别工具及其对以患者为中心的结局的影响提供有力证据。
