Potential Value of Point-of-Care Testing in Improving Outpatient Sepsis
- General practitioners are typically the first health care provider assessing patients with acute infections.
- This applies to sepsis cases as well
- Most sepsis cases begin outside the hospital:
- 75% of all sepsis patients admitted to the hospital were at home 4 days prior to hospital admission.
- 25% of patients with sepsis admitted to the hospital had a medical encounter within 7 days prior to hospitalization (Fay et al; JAMA 2020)
- Finding these patients in an outpatient environment would aid in early sepsis identification and intervention.
- Point-of-care testing (POCT) in primary care had experienced increased use due to its:
- Quick results (10-20 minutes)
- Bedside availability
- Ease of use (finger prick)
- Assessment of POCT sepsis biomarkers in sepsis suspected adults in the primary care setting may aid in early identification and improved outcomes.
- A recent evaluation of POCT of several sepsis biomarkers was published in patients with suspected infection in “out of hours” General Practitioner cooperative centers within the Netherlands.
- June 2018 to March 2020
- Investigators were blinded to patient outcome when assessing the impact of POCT results.
- Primary Outcome was predictive value of sepsis identification within 72 hours of evaluation using Sepsis-3 definitions
- Secondary outcomes were ICU admission within 72 hours, 30 day mortality or positive blood cultures.
- 336 patients: 141 Sepsis; 195 Without Sepsis
- The predictive value of the POCT Biomarkers was consistently poor.
- Biomarkers within the POCT could not markedly improve the predictability of sepsis in an outpatient population.
- POCT has increased in use over the past few years.
- None of the biomarkers tested added clinically relevant diagnostic information.
- Routine use of point of care testing of sepsis biomarkers in a general outpatient population cannot be recommended at the current time.
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Erkan Hassan is the Co-Founder & Chief Clinical Officer of Sepsis Program Optimization where he designs & oversees the implementation of solutions to optimize sepsis programs.
To discuss your organization’s Barriers of Effective Sepsis Care, contact Erkan by phone (844) 4SEPSIS (844-473-7747), email (email@example.com), or video chat.