Early-warning system for sepsis shown to improve survival rates and cut hospital stays

Date:
August 24, 2021
Source:
Case Western Reserve University
Summary:
Emergency room patients who were flagged by an
artificial-intelligence algorithm for possibly having sepsis
received antibiotics sooner and had better outcomes, according to
a study conducted by physician-researchers.



FULL STORY ========================================================================== Emergency room patients who were flagged by an artificial intelligence algorithm for possibly having sepsis received antibiotics sooner and
had better outcomes, according to a peer-reviewed study conducted by physician-researchers at Case Western Reserve University and MetroHealth.


========================================================================== Their findings were published August 20, in Critical Care Medicine,
the journal of the Society of Critical Care Medicine.

"We showed that when providers had access to the early warning system,
patients had better sepsis-related outcomes," said Yasir Tarabichi,
an assistant professor of medicine at the Case Western Reserve School
of Medicine and the study's principal investigator. "These patients
got their antibiotics faster and had, on average, more days 'alive and
out of hospital' than the group that had usual care. Taken together,
the increase in survival rates and reduction in hospital stay improved
with the implementation of the early warning system." Over five months
in 2019, the study's authors tracked nearly 600 patients who came into
the emergency department. MetroHealth implemented an electronic health record-embedded early warning system for sepsis.

Patients 18 and older presenting to the emergency department were
randomized to standard care for sepsis versus the pathway augmented by
the early warning system.

The early warning system alerted both the physicians and
pharmacists. This resulted in the patient who was flagged receiving
antibiotics significantly faster than those patients whose alert was
hidden, according to the study.

Collectively, those who received early antibiotics were measured to have
more days alive and out of the hospital more than those in the standard
care group.

"This study adds to the recent national discourse about sepsis early
warning systems," Tarabichi said. "Recent studies assessed how that score worked in isolation, which is not reflective of how it would actually be
used in the real world. We envisioned the early warning system's role as supportive to our health care team's response to sepsis. Most importantly,
we assessed the utility of the tool with the highest quality approach --
a randomized controlled study. In fact, our work stands out as the first published randomized controlled evaluation of a model-based early warning system in the emergency room setting." MetroHealth Senior Vice President
Brook Watts, a professor of medicine at the Case Western Reserve School
of Medicine, said the study demonstrates that from an institutional level, MetroHealth is committed to working collaboratively to try new approaches
to improve outcomes from patients.

"We rigorously validate and implement new tools that can help our
patients," said Watts, also an author of the study. "This was an
integrated team-based response to sepsis, with augmentation by artificial intelligence. It demonstrates our focus on quality improvement. We have
great providers and information service experts willing and interested
in leveraging new technology to improve patient care." The study was
written by: Tarabichi; Aurelia Cheng; David Bar-Shain; Brian M.

McCrate; Lewis H. Reese; Charles Emerman; Jonathan Siff; Christine Wang;
David C. Kaelber; Watts; and Michelle T. Hecker.

========================================================================== Story Source: Materials provided by Case_Western_Reserve_University. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Yasir Tarabichi, Aurelia Cheng, David Bar-Shain, Brian M. McCrate,
Lewis
H. Reese, Charles Emerman, Jonathan Siff, Christine Wang, David C.

Kaelber, Brook Watts, Michelle T. Hecker. Improving Timeliness
of Antibiotic Administration Using a Provider and Pharmacist
Facing Sepsis Early Warning System in the Emergency Department
Setting. Critical Care Medicine, 2021; Publish Ahead of Print DOI:
10.1097/CCM.0000000000005267 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/08/210824135353.htm

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