The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Identifying Patients With Sepsis on the Hospital Wards
Open accessAbstract
Sepsis contributes to up to half of all deaths in hospitalized patients, and early interventions, such as appropriate antibiotics, have been shown to improve outcomes. Most research has focused on early identification and treatment of patients with sepsis in the ED and the ICU; however, many patients acquire sepsis on the general wards. The goal of this review is to discuss recent advances in the detection of sepsis in patients on the hospital wards. We discuss data highlighting the benefits and limitations of the systemic inflammatory response syndrome (SIRS) criteria for screening patients with sepsis, such as its low specificity, as well as newly described scoring systems, including the proposed role of the quick sepsis-related organ failure assessment (qSOFA) score. Challenges specific to detecting sepsis on the wards are discussed, and future directions that use big data approaches and automated alert systems are highlighted.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“There is wide variation in diagnostic accuracy of these tools with most having poor predictive values, although the use of some was associated with improvements in care processes [28–31].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [29]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The third international consensus definitions for sepsis and septic shock (Sepsis-3).
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M., et al. (2016) · JAMA · doi:10.1001/jama.2016.0287 · Cited by 28,250
Bone, R. C., BALK, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M. H., & Sibbald, W. J. (1992) · CHEST Journal · doi:10.1378/chest.101.6.1644 · Cited by 13,317
Early goal-directed therapy in the treatment of severe sepsis and septic shock
Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., & Tomlanovich, M. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010307 · Cited by 10,743
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Angus, D. C., Linde-Zwirble, W. T., Lidicker, J., Clermont, G., Carcillo, J., & Pinsky, M. R. (2001) · Critical Care Medicine · doi:10.1097/00003246-200107000-00002 · Cited by 8,503
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-012-2769-8 · Cited by 7,371
Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun‐Buisson, C., Beale, R. J., et al. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0934-2 · Cited by 6,789
Kumar, A., Roberts, D., Wood, K. E., Light, B., Parrillo, J. E., Sharma, S., Suppes, R., Feinstein, D., Zanotti, S., Taiberg, L., et al. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000217961.75225.e9 · Cited by 6,109
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
Levy, M. M., Fink, M. P., Marshall, J. C., Abraham, E. H., Angus, D. C., Cook, D., Cohen, J., Opal, S. M., Vincent, J., & Ramsay, G. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000050454.01978.3b · Cited by 5,976
Seymour, C. W., Liu, V. X., Iwashyna, T. J., Brunkhorst, F. M., Rea, T. D., Scherag, A., Rubenfeld, G., Kahn, J. M., Shankar-Hari, M., Singer, M., et al. (2016) · JAMA · doi:10.1001/jama.2016.0288 · Cited by 3,939
Dombrovskiy, V. Y., Martin, A. A., Sunderram, J., & Paz, H. L. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000261890.41311.e9 · Cited by 1,253
Procalcitonin as a diagnostic marker for sepsis: A systematic review and meta-analysis.
Wacker, C., Prkno, A., Brunkhorst, F. M., & Schlattmann, P. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70323-7 · Cited by 1,198
Hospital Deaths in Patients With Sepsis From 2 Independent Cohorts
Liu, V. X., Escobar, G. J., Greene, J., Soule, J., Whippy, A., Angus, D. C., & Iwashyna, T. J. (2014) · JAMA · doi:10.1001/jama.2014.5804 · Cited by 993
Levy, M. M., Dellinger, R. P., Townsend, S. R., Linde‐Zwirble, W. T., Marshall, J. C., Bion, J., Schorr, C., Artigas, A., Ramsay, G., Beale, R. J., et al. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181cb0cdc · Cited by 965
Sepsis syndrome: a valid clinical entity. Methylprednisolone Severe Sepsis Study Group.
Bone, R. C., Fisher, C. J., Clemmer, T. P., Gj, S., METZ, C. A., & BALK, R. A. (1989) · PubMed · Cited by 689
Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007
Lagu, T., Rothberg, M. B., Shieh, M.-S., Pekow, P. S., Steingrub, J. S., & Lindenauer, P. K. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e318232db65 · Cited by 679
Becker, K. L., Snider, R. H., & Nylén, E. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318165babb · Cited by 606
A targeted real-time early warning score (TREWScore) for septic shock.
Henry, K. E., Hager, D. N., Pronovost, P. J., & Saria, S. (2015) · Science Translational Medicine · doi:10.1126/scitranslmed.aab3719 · Cited by 598
Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C., Beale, R. J., Osborn, T. M., Lemeshow, S. A., Chiche, J., Artigas, A., et al. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000723 · Cited by 583
Bone, R. C., Fisher, C. J., Clemmer, T. P., Slotman, G. J., METZ, C. A., & BALK, R. A. (1989) · Critical Care Medicine · doi:10.1097/00003246-198905000-00002 · Cited by 535
Taylor, R. A., Pare, J. R., Venkatesh, A. K., Mowafi, H. O., Melnick, E. R., Fleischman, W. M., & Hall, M. K. (2015) · Academic Emergency Medicine · doi:10.1111/acem.12876 · Cited by 513
Dear SIRS, I'm sorry to say that I don't like you
Vincent, J. (1997) · Critical Care Medicine · doi:10.1097/00003246-199702000-00029 · Cited by 442
Churpek, M. M., Zadravecz, F. J., Winslow, C. J., Howell, M. D., & Edelson, D. P. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201502-0275oc · Cited by 372
Self-citationSepsis incidence and outcome: Contrasting the intensive care unit with the hospital ward*
Esteban, A., Frutos–Vivar, F., Ferguson, N. D., Peñuelas, Ó., Lorente, J. A., Gordo, F., Honrubia, T., Algora, A., Bustos, A., García, G. V., et al. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000260960.94300.de · Cited by 370
Multicenter Development and Validation of a Risk Stratification Tool for Ward Patients
Churpek, M. M., Yuen, T. C., Winslow, C. J., Robicsek, A. A., Meltzer, D. O., Gibbons, R. D., & Edelson, D. P. (2014) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201406-1022oc · Cited by 263
Self-citationSepsis and Septic Shock: A History
Funk, D. J., Parrillo, J. E., & Kumar, A. (2009) · Critical Care Clinics · doi:10.1016/j.ccc.2008.12.003 · Cited by 253
Evaluation of Definitions for Sepsis
Knaus, W. A., Sun, X., Nyström, P.-O., & Wagner, D. P. (1992) · CHEST Journal · doi:10.1378/chest.101.6.1656 · Cited by 186
Development, implementation, and impact of an automated early warning and response system for sepsis
Umscheid, C. A., Betesh, J., VanZandbergen, C., Hanish, A., Tait, G., Mikkelsen, M. E., French, B. C., & Fuchs, B. D. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2259 · Cited by 173
Improved Sensitivity for Molecular Detection of Bacterial and Candida Infections in Blood
Bacconi, A., Richmond, G. S., Baroldi, M. A., Laffler, T. G., Blyn, L. B., Carolan, H. E., Frinder, M., TOLENO, D. M., Metzgar, D., Gutierrez, J. R., et al. (2014) · Journal of Clinical Microbiology · doi:10.1128/jcm.00801-14 · Cited by 172
Implementation of a real-time computerized sepsis alert in nonintensive care unit patients*
Sawyer, A. M., Deal, E. N., Labelle, A. J., Witt, C., Thiel, S. W., Heard, K., Reichley, R. M., Micek, S. T., & Kollef, M. H. (2011) · Critical Care Medicine · doi:10.1097/ccm.0b013e318205df85 · Cited by 169
Matot, I., & Sprung, C. L. (2001) · Intensive Care Medicine · doi:10.1007/pl00003795 · Cited by 153
An international sepsis survey: a study of doctors' knowledge and perception about sepsis
Poeze, M., Ramsay, G., Gerlach, H., Rubulotta, F., & Levy, M. (2004) · Critical Care · doi:10.1186/cc2959 · Cited by 148
Utility of a single early warning score in patients with sepsis in the emergency department
Corfield, A. R., Lees, F., Zealley, I. A., Houston, J. G., Dickie, S., Ward, K., McGuffie, A. C., & on behalf of the Scottish Trauma Audit Group Sepsis Steering Group (2013) · Emergency Medicine Journal · doi:10.1136/emermed-2012-202186 · Cited by 146
Validation of a Screening Tool for the Early Identification of Sepsis
Moore, L. J., Jones, S. L., Kreiner, L. A., McKinley, B. A., Sucher, J. F., Todd, S., Turner, K. L., Valdivia, A., & Moore, F. A. (2009) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e3181a3ac4b · Cited by 142
Churpek, M. M., Yuen, T. C., Park, S. Y., Gibbons, R. D., & Edelson, D. P. (2013) · Critical Care Medicine · doi:10.1097/ccm.0000000000000038 · Cited by 138
Self-citationKeep, J., Messmer, A. S., Sladden, R. A., Burrell, N., Pinate, R., Tunnicliff, M., & Glucksman, E. (2015) · Emergency Medicine Journal · doi:10.1136/emermed-2014-204465 · Cited by 126
Hooper, M. H., Weavind, L., Wheeler, A. P., Martin, J. B., Gowda, S. S., Semler, M. W., Hayes, R. M., Albert, D. W., Deane, N. B., Nian, H., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e318250a887 · Cited by 121
Early prediction of septic shock in hospitalized patients
Thiel, S. W., Rosini, J. M., Shannon, W. D., Doherty, J. A., Micek, S. T., & Kollef, M. H. (2010) · Journal of Hospital Medicine · doi:10.1002/jhm.530 · Cited by 103
Marshall, J. C. (2000) · Shock · doi:10.1097/00024382-200014060-00002 · Cited by 102
Billeter, A. T., Turina, M., Seifert, B., Mica, L., Stocker, R. A., & Keel, M. J. B. (2009) · World Journal of Surgery · doi:10.1007/s00268-008-9896-y · Cited by 98
Clinical Decision Support for Early Recognition of Sepsis
Amland, R. C., & Hahn-Cover, K. E. (2014) · American Journal of Medical Quality · doi:10.1177/1062860614557636 · Cited by 87
Ghanem‐Zoubi, N., Vardi, M., Laor, A., Weber, R., & Bitterman, H. (2011) · Critical Care · doi:10.1186/cc10102 · Cited by 87
Rohde, J. M., Odden, A., Bonham, C. A., Kuhn, L. E., Malani, P., Chen, L. M., Flanders, S. A., & Iwashyna, T. J. (2013) · Journal of Hospital Medicine · doi:10.1002/jhm.2012 · Cited by 82
Most Frequent Conditions in U.S. Hospitals, 2010
Pfuntner, A., Wier, L. M., & Stocks, C. (2013) · Cited by 68
Computer Protocol Facilitates Evidence-Based Care of Sepsis in the Surgical Intensive Care Unit
McKinley, B. A., Moore, L. J., Sucher, J. F., Todd, S., Turner, K. L., Valdivia, A., Sailors, R. M., & Moore, F. A. (2011) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31821598e9 · Cited by 63
Ross, E., Shieh, L. Y., Forsey, L. M., & Maggio, P. M. (2014) · Journal of Hospital Medicine · doi:10.1002/jhm.2291 · Cited by 51
Definitions of sepsis—Have we reached a consensus?
Sprung, C. L. (1991) · Critical Care Medicine · doi:10.1097/00003246-199107000-00001 · Cited by 43
The impact of an electronic medical record surveillance program on outcomes for patients with sepsis
McRee, L., Thanavaro, J. L., Moore, K. S., Goldsmith, M., & Pasvogel, A. E. (2014) · Heart & Lung · doi:10.1016/j.hrtlng.2014.05.009 · Cited by 35
Identifying Severe Sepsis via Electronic Surveillance
Brandt, B., Gartner, A., Moncure, M., Cannon, C. M., Carlton, E. F., Cleek, C., Wittkopp, C., & Simpson, S. Q. (2014) · American Journal of Medical Quality · doi:10.1177/1062860614541291 · Cited by 28
Amland, R. C., Lyons, J., Greene, T. L., & Haley, J. M. (2015) · JRSM Open · doi:10.1177/2054270415609004 · Cited by 26
Developing an Early Sepsis Alert Program
Buck, K. (2013) · Journal of Nursing Care Quality · doi:10.1097/ncq.0b013e3182a98182 · Cited by 25
An Interprofessional Process to Improve Early Identification and Treatment for Sepsis
Palleschi, M. T., Sirianni, S., O’Connor, N., Dunn, D., & Hasenau, S. M. (2013) · Journal for Healthcare Quality · doi:10.1111/jhq.12006 · Cited by 20
Septicaemia--the clinical diagnosis
Bihari, D. (1990) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/25.suppl_c.1 · Cited by 20
Reduction in Time to First Action as a Result of Electronic Alerts for Early Sepsis Recognition
Kurczewski, L., Sweet, M. A., McKnight, R., & Halbritter, K. (2015) · Critical Care Nursing Quarterly · doi:10.1097/cnq.0000000000000060 · Cited by 16
Detecting Sepsis: Are Two Opinions Better Than One?
Bhattacharjee, P., Churpek, M. M., Snyder, A. M., Howell, M. D., & Edelson, D. P. (2017) · Journal of Hospital Medicine · doi:10.12788/jhm.2721 · Cited by 10
Self-citationDellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., Reinhart, K., Angus, D. C., Brun-Buisson, C., Beale, R., et al. (2008) · Critical Care Medicine · doi:10.1097/01.ccm.0000298158.12101.41 · Cited by 9
Odden, A., Govindan, S., Sheth, J. S., & Iwashyna, T. J. (2015) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201502-096le · Cited by 8
NEWS and Sepsis Screening Tool
Haidrani, L. (2016) · Emergency Nurse · doi:10.7748/en.24.2.13.s14 · Cited by 1
Flagged first, then by citations
Cited by
Sorted by citations
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935
Sepsis associated acute kidney injury
Poston, J. T., & Koyner, J. L. (2019) · BMJ · doi:10.1136/bmj.k4891 · Cited by 917
Fernando, S. M., Tran, A., Taljaard, M., Cheng, W., Rochwerg, B., Seely, A. J. E., & Perry, J. J. (2018) · Annals of Internal Medicine · doi:10.7326/m17-2820 · Cited by 281
Prediction of sepsis patients using machine learning approach: a meta-analysis
Islam, M. M., Nasrin, T., Walther, B. A., Wu, C.-C., Yang, H.-C., & Li, Y.-C. (2019) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2018.12.027 · Cited by 259
Kaur, S., Singla, J., Nkenyereye, L., Jha, S., Prashar, D., Joshi, G. P., El–Sappagh, S., Islam, M. S., & Islam, S. M. R. (2020) · IEEE Access · doi:10.1109/access.2020.3042273 · Cited by 289
Metadata
- Authors
- Bhattacharjee, P., Edelson, D. P., & Churpek, M. M.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Churpek, Matthew M.
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 151
- Issue
- 4
- Pages
- 898-907
- ISSN
- 0012-3692 (ISSN-L)
- PMC
- PMC5472513
- OpenAlex
- W2465673526
- Cited by
- 120
- References
- 57
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 12 · 2023: 11 · 2022: 9 · 2021: 15 · 2020: 17 · 2019: 19 · 2018: 11 · 2017: 11
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CHEST Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Agency for Healthcare Research and Quality (T32HS000078)
- National Heart, Lung, and Blood Institute (K08HL121080)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- sepsis, sepsis detection, hospital wards, systemic inflammatory response syndrome, SIRS criteria, qSOFA score, sepsis screening, scoring system, automated alert system, big data
- MeSH terms
- Diagnosis, Differential, Hospitalization, Humans, Hospital Mortality, Systemic Inflammatory Response Syndrome, Sepsis, Decision Support Systems, Clinical, Organ Dysfunction Scores
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review