Safer from Sepsis in Australia
11 February 2020
New research from Macquarie University shows the Sepsis Kills adult sepsis pathway, developed by the Clinical Excellence Commission and used in NSW hospitals, is more effective than an internationally recommended model.
The findings are in the Internal Medicine Journal and show the NSW model is more likely to trigger a warning of patient deterioration from sepsis than the internationally recommended Quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA).
CEC Director Systems Improvement Dr Harvey Lander welcomed the findings which call on all Australian hospitals to follow the NSW lead and use the Sepsis Kills adult sepsis pathway (ASP).
"We welcome findings which demonstrate the pathways being used in NSW, including the new electronic sepsis alert, are highly effective in supporting the early detection of sepsis and therefore improved patient outcomes," Dr Lander said.
"We know sepsis is a global health priority and is the leading cause of death in hospital patients worldwide.
"Rapid detection of sepsis and starting antibiotic treatment within one hour is critical to improved patient outcomes so we welcome findings which show the NSW Sepsis Kills program is leading international standards in this early detection of symptoms."
The study finds that while early detection of sepsis is the best defence against this often-fatal blood-borne infection, for two-thirds of cases in the study, qSOFA would not have triggered a warning of sepsis before the patient's death.
Lead author of the paper, Associate Professor Ling Li from the Australian Institute of Health Innovation at Macquarie University, states the Sepsis Kills ASP would have triggered a warning for more than 90% of cases who died in hospital and the warning would have been triggered 8 days before death for half of cases; while in two thirds of cases, qSOFA would have triggered no warning at all before the patient died.
"qSOFA has been put forward as an effective tool for early detection of sepsis however our research shows this is not the case and we are calling on all Australian hospitals to use ASP to ensure the best care for patients," Associate Professor Li said.
Despite advances in care, sepsis remains a huge burden and both ASP and qSOFA were devised to prompt clinicians at a patient's bedside to consider certain criteria, in assessing the possibility of sepsis. This research shows that the use of ASP is more effective for detecting the early warning signs of potential sepsis, improving the patient's chance of survival.
Both ASP and qSOFA are paper based systems and Associate Professor Li says the future will be in developing automated systems to support clinicians in the early detection of sepsis.
Recently, a team from the Australian Institute of Health Innovation led by Associate Professor Li, completed an evaluation and optimisation of automated clinical systems to improve early sepsis diagnosis and rapid treatment. This research has been adopted by the Clinical Excellence Commission and eHealth NSW for future rollout in NSW.