Outcomes of Adolescent Sepsis Cases in Community Hospital ED

Healthday News — A typical emergency department sees few cases of sepsis among adolescents, according to a research letter published in JAMA Pediatrics.

Following the case of Rory Staunton, who was seen in an emergency department, discharged, and subsequently died of septic shock in 2012, Idris V.R. Evans, MD, from the University of Pittsburgh School of Medicine, and colleagues examined the electronic health records of healthy adolescents who presented to 12 emergency departments with signs and symptoms similar to those of Rory Staunton.

The researchers found that 2.0% of the 43,654 healthy adolescents who were evaluated at the 12 emergency departments had 3 or more systemic inflammatory response syndrome criteria. 

Overall, 17.6% of these cases (158 patients) were suspected of having infection and met the sepsis criteria; 7.0% (11 patients) were suspected of infection after 24 hours. A total of 15.8% of the patients were admitted to the intensive care unit, and 0.6% died; the 1 adolescent who died received antibiotics 19 hours following presentation. Each year, an emergency department treated a mean of 36,357 patients, of whom 25 presented similarly to Rory Staunton, and 4 had sepsis. Every 100 years, each emergency department would treat 2.8 fatal sepsis cases.

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“Health care policy is often motivated by powerful anecdotes, such as the case of Rory Staunton,” the authors write. “However, it is important to be explicit about the goals and challenges of any proposed policy so that policy makers and the public are not disappointed if expectations are not met.”

One author disclosed financial ties to the biomedical industry.

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Evans IVR, Scott Watson R, Carcillo J, et al. epidemiology of sepsis among adolescents at community hospital emergency departments: implications for Rory’s regulations [published online August  14, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.1915