Background: The prehospital care of patients with sepsis are commonly performed by the emergency medical\nservices. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients\nwith sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse\nprognosis. Therefore, early identification of patients with sepsis is important, and more information about the\nprehospital characteristics that can be used to identify these patients is needed. Based on this lack of information,\nthe objectives of this study were to investigate the prehospital characteristics that are identified while patients with\nsepsis are being transported to the hospital by the emergency medical services, and to compare these values to\nthose of the patients with and without adverse outcomes during their hospital stays.\nMethods: This was a retrospective observational study. The patientsâ?? electronic health records were reviewed and\nselected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an\nemergency department by the emergency medical services. Data were collected on demographics, prehospital\ncharacteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit,\nand analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital\ncharacteristics for predicting or development of adverse outcome were analysed.\nResults: In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing\npatients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serum\nglucose level and altered mental status during prehospital care were found to be associated with an adverse\noutcome.\nConclusions: The findings suggests that patients having a decreased oxygen saturation and body temperature,\nincreased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient\nprognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with\nsepsis early and improve their long-term outcomes. However further research is required to predict limit values of\nsaturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients\nwith sepsis.
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