Macquarie University, Sydney, New South Wales, Australia.
Clinical Excellence Commission, Sydney, New South Wales, Australia.
Stud Health Technol Inform. 2024 Jan 25;310:314-318. doi: 10.3233/SHTI230978.
Sepsis is a global health priority associated with high mortality. Clinical decision support systems have been developed to support clinicians with sepsis management. Ordering blood cultures (BCs) for suspected sepsis patients are strongly recommended by clinical guidelines. However, limited evidence exists investigating BC ordering following sepsis alerts and subsequent patient outcomes. This study aimed to investigate this issue using electronic health record data from an acute care hospital in Australia. Of 4,092 patients, only 16.6% had a BC ordered following a sepsis alert. The median time from the first sepsis alert to a BC order was 15.3 hours. Patients had 5.89 times higher odds of being diagnosed with sepsis if a BC was ordered following a sepsis alert than those without BC ordered (p<0.0001). Further investigation is needed to understand reasons behind the delay or failure to order a BC despite receiving electronic sepsis alerts and how decision support can be optimized to improve patient outcomes.
脓毒症是一个全球性的健康重点问题,与高死亡率相关。已经开发了临床决策支持系统来帮助临床医生管理脓毒症。临床指南强烈建议对疑似脓毒症患者进行血培养 (BC) 检测。然而,对于脓毒症警报后进行 BC 检测以及随后的患者结局,现有证据有限。本研究旨在使用来自澳大利亚一家急性护理医院的电子健康记录数据来调查这个问题。在 4092 名患者中,只有 16.6%的患者在脓毒症警报后进行了 BC 检测。从第一个脓毒症警报到进行 BC 检测的中位数时间为 15.3 小时。如果在脓毒症警报后进行了 BC 检测,那么患者被诊断为脓毒症的可能性是未进行 BC 检测的患者的 5.89 倍 (p<0.0001)。尽管收到了电子脓毒症警报,但仍需要进一步调查延迟或未能进行 BC 检测的原因,以及如何优化决策支持以改善患者结局。