A Retrospective Review of the Sepsis Definition after Publication of Sepsis-3.
Am J Med. 2018 Nov 20;:
Authors: Braun D
PURPOSE: To determine if the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) was being utilized in defining sepsis in the clinical setting.
BACKGROUND: Two and one-half years after the introduction of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), clinicians continue to not be documenting Sequential Organ Failure Assessment (SOFA) scores. There continues to be variations in what standard is accepted by both commercial payers and CMS in diagnosing sepsis.
METHODS: One hundred patients between February 2016 through March 2018 who were diagnosed with sepsis were retrospectively reviewed for the presence of criteria for the diagnosis of sepsis. Data points for SOFA criteria were analyzed.
RESULTS: None of the septic patients were diagnosed utilizing Sequential Organ Failure Assessment (SOFA) scores. Many of the data points were found to not have been collected or measured to complete a SOFA score.
CONCLUSIONS: Due to Sepsis-3 criteria not being accepted by Centers for Medicare and Medicaid (CMS) as well as the Infectious Disease Society of America along with it not being able to be operationalized for use in the clinical setting, it is recommended to continue utilizing SIRS criteria plus infection while Sepsis-3 continues to be evaluated. It will also allow for some time to study any effect it may have on patient outcomes. There is also a need for a uniform definition of sepsis.
PMID: 30468722 [PubMed - as supplied by publisher]