| Autor: |
Daniel B. Goldish, Erica L. Bechtel, Margaret W. Jones, David J. Carlbom, Stephen P. Burns, Deborah A. Crane |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
PMR : the journal of injury, function, and rehabilitation. |
| ISSN: |
1934-1563 |
| Popis: |
To determine the positive predictive value (PPV) of a sepsis screening protocol in patients with cervical spinal cord injury (SCI).Retrospective review of all patients with cervical SCI screening positive for ≥ two systemic inflammatory response syndrome (SIRS) criteria while hospitalized on acute care or inpatient rehabilitation units over a 3.5-year period. Sepsis was defined by the occurrence of: (1) any culture order followed by an intravenous (IV) antibiotic within 72 hours or (2) an IV antimicrobial followed by a culture order within 24 hours.134 patients screened positive for ≥ two SIRS criteria. Of these, 36 (26.9%) were diagnosed with sepsis. Factors associated with a true-positive SIRS screen on multivariable analysis included American Spinal Injury Association Impairment Scale (AIS) grade A-C (versus D; p0.001). The PPV of the screen was 38% in patients with AIS A-C and 9% in patients with AIS D. Altered mental status was strongly associated with the diagnosis of sepsis; 16/18 (88.9%) of those with AMS had sepsis (p0.001). Age, sex, and neurologic level of injury were not associated with true-positive screening. For patients with new SCI, the first true-positive screen occurred a median of 31 days post-injury. The most common SIRS criteria combinations in patients with true-positive screens were elevated heart rate and either abnormal white blood cell count (43% of true positives) or abnormal temperature (26% of true positives). Abnormally low body temperature (36Sepsis screening using SIRS criteria in hospitalized patients with tetraplegia has a PPV of 26.9%; it is significantly higher in patients with AIS A-C versus D injuries. AMS, when combined with a positive SIRS screening, is strongly associated with sepsis. This article is protected by copyright. All rights reserved. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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