Sepsis prevalence among patients with suspected infection in emergency department: a multicenter prospective cohort study.

OBJECTIVE: In the emergency department (ED), the early identification of patients suspected of infection is a challenge for emergency physicians. Sepsis prevalence among patients with suspected infection in the ED remains uncertain. Our objective was to determine how many cases of sepsis occurred among patients with suspected infections in the ED. METHODS: This multi-center, prospective, observational study was conducted in 19 EDs in France. For 1 week, all consecutive ED patients with suspected infection (according to the emergency physician) were included. The primary endpoint was the prevalence of sepsis in the ED according to the 'sepsis-3' definition. Secondary endpoints involved comparisons among patients with and without sepsis. RESULTS: During the study period, 13 904 patients were screened; 494 (3.6%) consulted for suspected infection and were included in the study. Among them, 172 patients [39%, 95% confidence interval (CI) (34-44)] were diagnosed with sepsis. The total hospital mortality for patients with a suspected infection was 4.7% and the hospital mortality for sepsis patients was 9.9%. CONCLUSION: In the ED, among patients with a suspected infection, the prevalence of sepsis as per the 'sepsis-3' definition was 39% [95% CI (34-44)].

[Acute coronary syndrome: an analyse of complications during interhospital transports to interventional coronary departments]. / Syndrome coronaire aigu: analyse des complications lors des transferts interhospitaliers depuis un centre hospitalier général vers les plateaux de cardiologie interventionnelle.

OBJECTIVES: The management of acute coronary syndrome (ACS) has one major objective today: early myocardial reperfusion. This results in a growing number of interhospital transfers of patients with ACS from general hospitals towards hospitals with interventional cardiology departments. This study's aim was to analyze the complications during transfers to assess the need for changes in transfer procedures. METHOD: Prospective single-center study over 6 months, including all patients transferred for ACS (regardless of whether or not they were ST+) to an interventional cardiology department. RESULTS: The study included 48 patients, with an average age of 68 years and a sex ratio of 3 men per woman. 25% had a complication during transfer, with resumption of pain, dysrhythmia or shock. There were no deaths during the course of transfer. 92% of complications occurred among patients coming from an emergency unit, compared with 8% coming from a cardiology intensive care unit. ACS had begun within the past 24 hours for all. DISCUSSION: This high incidence justifies careful medical supervision of interhospital transfers for patients with an ACS < 24 hours. No patients transferred more than 24 hours after the onset of ACS developed complications. Further studies of this type of patient are necessary to determine the needs of this group.