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Prediction of the R...
Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
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- Olander, Agnes (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen
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- Magnusson, Carl, 1976 (author)
- Gothenburg University,Göteborgs universitet,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden,PreHospen,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Sundler, Annelie Johansson, 1973- (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd
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- Bremer, Anders, Docent, 1957- (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Linnaeus University, Faculty of Health and Life Sciences, Växjö, Sweden
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- Andersson, Henrik, 1968- (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Linnaeus University, Faculty of Health and Life Sciences, Växjö, Sweden
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- Herlitz, Johan, 1949- (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd
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- Axelsson, Christer (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen
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- Andersson Hagiwara, Magnus (author)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen
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(creator_code:org_t)
- 2023-02-08
- 2023
- English.
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In: Prehospital and Disaster Medicine. - : Cambridge University Press (CUP). - 1049-023X .- 1945-1938. ; 38:2, s. 160-167
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Abstract
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- Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- ambulance clinician
- ambulance service
- glucose
- lactate
- sepsis
- Människan i vården
- The Human Perspective in Care
- ambulance clinician
- ambulance service
- glucose
- lactate
- sepsis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Olander, Agnes
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Magnusson, Carl, ...
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Sundler, Annelie ...
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Bremer, Anders, ...
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Andersson, Henri ...
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Herlitz, Johan, ...
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Axelsson, Christ ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Nursing
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Prehospital and ...
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University of Borås
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University of Gothenburg