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A Retrospective Review of the Sepsis Definition after Publication of Sepsis-3

Published:November 21, 2018DOI:https://doi.org/10.1016/j.amjmed.2018.11.003

      Abstract

      Background

      Two and a half years after the introduction of Sepsis-3, clinicians continue not to document Sequential Organ Failure Assessment (SOFA) scores. There continue to be variations in what standard is accepted by both commercial payers and the Centers for Medicare and Medicaid (CMS) in diagnosing sepsis. The purpose of this review is to determine if the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were being utilized in defining sepsis in the clinical setting.

      Methods

      One hundred patients between February 2016 and March 2018 who were diagnosed with sepsis were retrospectively reviewed for the presence of criteria for the diagnosis of sepsis. Data points for SOFA criteria were analyzed.

      Results

      None of the septic patients were diagnosed utilizing SOFA scores. Many of the data points were found to not have been collected or measured to complete a SOFA score.

      Conclusions

      Due to Sepsis-3 criteria not being accepted by CMS or the Infectious Disease Society of America, along with it not being able to be operationalized for use in the clinical setting, it is recommended to continue utilizing systemic inflammatory response syndrome criteria plus infection while Sepsis-3 continues to be evaluated. It will also allow for some time to study any effect it may have on patient outcomes. There is also a need for a uniform definition of sepsis.

      Keywords

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