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Article

Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever

1
Infectious Disease Unit, Azienda Sanitaria Universitaria Integrata di Udine (ASU FC), 33100 Udine, Italy
2
Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
3
Emergency Department, North-West District, Tuscany Health Care, Spedali Riuniti Livorno, 57124 Livorno, Italy
4
Department of Public Health, Clinical and Molecular Medicine, Università degli Studi di Cagliari, 09124 Cagliari, Italy
5
U.O. Lipoaferesi, Fondazione Toscana “Gabriele Monasterio”, Via Moruzzi,1, 1, 56124 Pisa, Italy
6
Deep Health Unit, Fondazione Toscana “Gabriele Monasterio”, Via Moruzzi, 1, 56124 Pisa, Italy
7
SIMNOVA-Interdepartment Centre for Innovative Teaching and Simulation in Medicine and the Health Professions (Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie), University of Eastern Piedmont, 28100 Novara, Italy
8
Neuro Intensive Care Unit, Department of Anesthesia, Careggi Universital Hospital, 50139 Florence, Italy
9
Internal Medicine Unit, Felice Lotti Hospital, Pontedera, Azienda USL Toscana Nord-Ovest, 1, 56124 Pisa, Italy
10
Emergency Medicine, University Hospital of Pisa, 56124 Pisa, Italy
11
Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Antonio Mirijello and Alberto Tosoni
Received: 29 April 2021 / Revised: 6 June 2021 / Accepted: 10 June 2021 / Published: 12 June 2021
(This article belongs to the Special Issue New Strategies for Treatment of Sepsis)
Background and Objectives: Chances of surviving sepsis increase markedly upon prompt diagnosis and treatment. As most sepsis cases initially show-up in the Emergency Department (ED), early recognition of a septic patient has a pivotal role in sepsis management, despite the lack of precise guidelines. The aim of this study was to identify the most accurate predictors of in-hospital mortality outcome in septic patients admitted to the ED. Materials and Methods: We compared 651 patients admitted to ED for sepsis (cases) with 363 controls (non-septic patients). A Bayesian mean multivariate logistic regression model was performed in order to identify the most accurate predictors of in-hospital mortality outcomes in septic patients. Results: Septic shock and positive qSOFA were identified as risk factors for in-hospital mortality among septic patients admitted to the ED. Hyperthermia was a protective factor for in-hospital mortality. Conclusions: Physicians should bear in mind that fever is not a criterium for defining sepsis; according to our results, absence of fever upon presentation might be indicative of greater severity and diagnosis of sepsis should not be delayed. View Full-Text
Keywords: afebrile patients; emergency department; sepsis; septic shock; qSOFA afebrile patients; emergency department; sepsis; septic shock; qSOFA
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MDPI and ACS Style

Sozio, E.; Bertini, A.; Bertolino, G.; Sbrana, F.; Ripoli, A.; Carfagna, F.; Giacinta, A.; Viaggi, B.; Meini, S.; Ghiadoni, L.; Tascini, C. Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever. Medicina 2021, 57, 612. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060612

AMA Style

Sozio E, Bertini A, Bertolino G, Sbrana F, Ripoli A, Carfagna F, Giacinta A, Viaggi B, Meini S, Ghiadoni L, Tascini C. Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever. Medicina. 2021; 57(6):612. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060612

Chicago/Turabian Style

Sozio, Emanuela, Alessio Bertini, Giacomo Bertolino, Francesco Sbrana, Andrea Ripoli, Fabio Carfagna, Alessandro Giacinta, Bruno Viaggi, Simone Meini, Lorenzo Ghiadoni, and Carlo Tascini. 2021. "Recognition in Emergency Department of Septic Patients at Higher Risk of Death: Beware of Patients without Fever" Medicina 57, no. 6: 612. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060612

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