Chafranska et al identified predictors of mortality for patients presenting to the Emergency Department with apparent infection. These can help to identify patients who may benefit from more aggressive management. The authors are from Copenhagen University Hospital and Slagelse Hospital in Denmark.
Patient selection: Emergency Department (ED) patient with suspected infection, age 60 to 83 years
Mortality rate in the next 2.1 years: 36%
Predictors associated with mortality:
(1) older age (aHR 1.05)
(2) male gender (aHR 1.2)
(3) cancer (aHR 1.8)
(4) alcohol misuse (aHR 1.3)
(5) history of sepsis within the past year (aHR 1.6)
(6) SOFA score >= 2 at admission to the ED (aHR 1.9)
(7) SIRS criteria >= 1 at admission to the ED (aHR 1.2)
(8) length of hospital stay (aHR 1.05)
(9) devices and implants as the source of infection (aHR 7.0)
where:
• Infection of device or implant has a risk significantly higher than the others.
• Item 8 (length of hospital stay) will not be included in the implementation since not known in the ED.
Factors reducing the risk of mortality:
(1) skin infection (aHR 0.62)
(2) higher hemoglobin concentration on arrival to the ED (aHR 0.86; this could be viewed as anemia being a risk factor for mortality)
