Emergency departments see few cases of sepsis in adolescents

(HealthDay)—A typical emergency department sees few cases of sepsis among adolescents, according to a research letter published online Aug. 14 in JAMA Pediatrics.

Following the case of Rory Staunton, who was seen in an emergency department, discharged, and subsequently died of septic shock in 2012, Idris V.R. Evans, M.D., from the University of Pittsburgh School of Medicine, and colleagues examined the electronic health records of healthy adolescents who presented to 12 emergency departments with signs and symptoms similar to those of Rory Staunton.

The researchers found that 2.0 percent of the 43,654 healthy adolescents who were evaluated at the 12 emergency departments had three or more systemic inflammatory response syndrome criteria. Overall, 17.6 percent of these cases (158 patients) were suspected of having infection and met the sepsis criteria; 7.0 percent (11 patients) were suspected of infection after 24 hours. A total of 15.8 percent of the patients were admitted to the intensive care unit, and 0.6 percent died; the one adolescent who died received antibiotics 19 hours following presentation. Each year, an emergency department treated a mean of 36,357 patients, of whom 25 presented similarly to Rory Staunton, and four had sepsis. Every 100 years, each emergency department would treat 2.8 fatal sepsis cases.

"Health care policy is often motivated by powerful anecdotes, such as the case of Rory Staunton," the authors write. "However, it is important to be explicit about the goals and challenges of any proposed policy so that policy makers and the public are not disappointed if expectations are not met."

One author disclosed financial ties to the biomedical industry.

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