Evaluation of the Sepsis Screening Tool’s Efficacy in Assessing Organ Dysfunction

Background: Sepsis is a life threatening condition caused by the dysregulation of the immune system due to multiple organ dysfunction. It is usually caused by an infection that can affect the respiratory, neurological, circulatory, and metabolic systems. The best way to help these patients is to give them the appropriate care as quickly as possible. In order to help make this possible, a sepsis screening tool was developed for patients at Cook Children’s Medical Center (CCMC). Purpose: The purpose of this project was to see if patients screened for sepsis were less likely to develop organ dysfunction. A new adult definition of sepsis was developed in February 2016 by the European Society of Intensive Care Medicine and the Society of Critical Care Medicine; this definition, modified to apply pediatric norms, was applied at CCMC in order to assess the level of organ dysfunction in children. Methods: The level of organ dysfunction was based on the first set of vitals at admission to the pediatric intensive care unit (PICU) at CCMC. To be included in this study, patients had to have had an initial PICU visit between the dates of 10/12-5/16, and the providers’ diagnoses had to have included billing codes related to sepsis. There were 520 patients meeting these criteria. Patients were screened for respiratory, neurological, circulatory, or metabolic dysfunction, and then were given an organ dysfunction score. Results: The results showed that 82% of the patients who were not screened had organ dysfunction compared to only 69% of those for which the sepsis screening tool was utilized. Thus, those who were not screened were more likely to have organ dysfunction than those who were screened, P=.001, OR=2.08. Among those screened, patients with positive screens (73%) were more likely to have organ dysfunction than those with negative screens (60%), P=.03, OR=1.78. Conclusions: In conclusion, patients who were screened were significantly less likely to have organ dysfunction than those who were not screened, and among those screened, those with positive screens were significantly more likely to have organ dysfunction. The tool successfully assessed the risk of sepsis and septic shock at CCMC and could be used to increase sepsis awareness if it was to be used at other hospitals.