Screening for sepsis in general hospitalized patients: a systematic review
Abstract
Background Sepsis is a condition widely observed outside critical care areas.Aim To examine the application of sepsis screening tools for early recognition of sepsis in general hospitalized patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation; and (iii) describe the implementation process.Methods A systematic review method was used. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and Embase databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients. The review protocol was registered with PROSPERO (CRD42016042261).Findings More than 8000 citations were screened for eligibility after duplicates had been removed. Six articles met the inclusion criteria testing two types of sepsis screening tools. Electronic tools can capture, recognize abnormal variables, and activate an alert in real time. However, accuracy of these tools was inconsistent across studies with only one demonstrating high specificity and sensitivity. Paper-based, nurse-led screening tools appear to be more sensitive in the identification of septic patients but were only studied in small samples and particular populations. The process of care measures appears to be enhanced; however, demonstrating improved outcomes is more challenging. Implementation details are rarely reported. Heterogeneity of studies prevented meta-analysis.Conclusion Clinicians, researchers and health decision-makers should consider these findings and limitations when implementing screening tools, research or policy on sepsis recognition in general hospitalized patients.
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Sepsis screening tools vary widely in diagnostic accuracy, with most having poor predictive values, although use of some is associated with improvements in care processes.
“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 [28]
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- Authors
- Alberto, L., Marshall, A. P., Walker, R., & Aitken, L. M.
- Affiliations
- Griffith University (AU)
- Corresponding author
- Alberto, L.
- Venue
- Journal of Hospital Infection
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 96
- Issue
- 4
- Pages
- 305-315
- ISSN
- 0195-6701 (ISSN-L)
- OpenAlex
- W2612834622
- Cited by
- 54
- References
- 41
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 12 · 2020: 6 · 2019: 4 · 2018: 5
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hospital Infection (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Keywords
- sepsis, sepsis screening, early recognition, hospitalized patients, electronic alert system, nurse-led screening, screening accuracy, implementation, process of care
- MeSH terms
- Hospitals, Humans, Inpatients, Mass Screening, Sepsis, Early Diagnosis
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