Table 2 Prevalence of keywords exceeding 20% among ED patients discharged with ICD-10 code sepsis*
Order | Keyword [5] | Prevalence | P value** | |||||
|---|---|---|---|---|---|---|---|---|
Entire sample of ED patients (N = 479) | EMS group (n = 357) | non-EMS group (n = 122) | ||||||
Number | Percent (%) and 95% CI | Number | Percent (%) and 95% CI | Number | Percent (%) and 95% CI | |||
1 | Abnormal, or suspected abnormal temperature In turn including primary keywords shivering OR hypothermia OR the following combined keywords: Confirmed or suspected fever, confirmed abnormal temperature (confirmed fever or hypothermia) | 319 | 66.6 (62.3-70.7) | 232 | 65.0 (60.0-69.8) | 87 | 71.3 (62.7-78.6) | 0.201 |
2 | Pain Abdominal/extremity/back/undefined/urinary tract/joint/chest/general/headache/throat/wound/painful muscle cramp/positive Pasternatsy’s sign (costovertebral angle tenderness) | 230 | 48.0 (43.6-52.5) | 143 | 40.1 (35.1-45.2) | 87 | 71.3 (62.7-78.6) | < 0.001 |
3 | Abnormal breathing Tachypnea, low oxygen saturation, airway secretions, breathing difficulties, cough, or obstructive breathing | 210 | 43.8 (39.5-48.3) | 185 | 51.8 (46.7-57.0) | 25 | 20.5 (14.3-28.5) | < 0.001 |
4 | Risk factors for sepsis Known ongoing or recent infection, current antibiotic treatment, recent invasive procedures, substance abuse, compromised immune system, chronically compromised breathing | 172 | 35.9 (31.7-40.3) | 110 | 30.8 (26.3-35.8) | 62 | 50.8 (42.1-59.5) | < 0.001 |
5 | Abnormal circulation Weak pulse or difficulties to palpate the pulse, peripheral coldness, cardiac arrest, tachycardia, low blood pressure, prolonged capillary refill time or non-measurable circulatory variables | 163 | 34.0 (29.9-38.4) | 137 | 38.4 (33.5-43.5) | 26 | 21.3 (15.0-29.4) | 0.001 |
6 | Temporal deterioration Stated deterioration or expressions describing a temporal change | 144 | 30.1 (26.1--34.3) | 102 | 28.6 (24.1-33.5) | 42 | 34.4 (26.6-43.2) | 0.223 |
7 | Gastrointestinal symptoms Vomiting, diarrhea, reduced amount of stool, gastrointestinal bleeding, obstipation, pale feces | 137 | 28.6 (24.7-32.8) | 104 | 29.1 (24.7-34.1) | 33 | 27.0 (20.0-35.5) | 0.660 |
8 | Acute altered mental status Abnormal behavior or level of consciousness (excluding previously known dementia or mental retardation without statement worse) OR abnormal verbal response defined as no/decreased verbal response | 127 | 26.5 (22.8-30.6) | 111 | 31.1 (26.5-36.1) | 16 | 13.1 (8.2-20.2) | < 0.001 |
9 | Abnormal skin Paleness, wounds or wound infection, sweaty, cyanosis, redness, icterus, mottling, bruises, rash, blisters, or peteckiae, change of skin turgor, exuding skin | 125 | 26.1 (22.4-30.2) | 96 | 26.9 (22.6-31.7) | 29 | 23.8 (17.1-32.1) | 0.498 |
10 | Abnormal urination Abnormal urination (such as hematuria without trauma, bad smelling or cloudy urine, increased frequency of urination) OR urinary tract pain OR decreased urinary volumes OR dysfunction of urinary catheters defined as obstruction/leakage/problematic urinary catheters including nefrostomias | 118 | 24.6 (21.0-28.7) | 92 | 25.8 (21.5-30.6) | 26 | 21.3 (15.0-29.4) | 0.324 |
11 | Loss of energy Defined as fatigue, weakness, faintness or similar expressions | 113 | 23.6 (20.0-27.6) | 91 | 25.5 (21.3-30.3) | 22 | 18.0 (12.2-25.8) | 0.094 |
12 | Decreased mobility in turn including primary keywords remained sitting or lying in an abnormal way OR decreased miscellaneous mobility OR the following combined keywords: “weakness of the legs” and “fallen or being found on the floor” | 106 | 22.1 (18.6-26.1) | 93 | 26.1 (21.8-30.8) | 13 | 10.7 (6.3-17.4) | < 0.001 |