University of California at Davis researchers have found that routine information such as blood pressure, respiratory rate, temperature, and white blood cell count obtained from the EHRs of hospitalized patients can be used to predict early stages of sepsis, a leading cause of death and hospitalization in the U.S. They have also determined that just three measures including lactate level, blood pressure, and respiratory rate can pinpoint the likelihood that a patient will die from the disease.
Sepsis is an immune system response to infection that can damage organs and cause permanent physical and mental disabilities. It is associated with increased blood levels of lactate, an acid produced when organs receive too little oxygen.
Patients are rarely screened for blood lactate levels because sepsis is very hard to distinguish in its early stages. The blood test also lacks specificity, as many patients with elevated lactate do not have sepsis.
While early treatment with broad spectrum antibiotics and intravenous fluids is associated with better outcomes for those individuals with sepsis, the potential harm from those treatments for low risk patients far outweighs the benefits.
During the study, the researchers analyzed data from the EHRs of 741 patients with sepsis at the UC Davis Medical Center during 2010. They found that vital signs combines with serum white blood cell count could accurately predict high lactate levels and sepsis. Now the research team is working on a specific sepsis-risk algorithm that could be automatically calculated from EHRs.
“Finding a precise and quick way to determine which patients are at high risk for developing the disease is critically important”, said Hien Nguyen, Associate Professor of Internal Medicine and Medical Director of EHRs at UC Davis. “We wanted to see if EHRs could provide the foundation for knowing when aggressive diagnosis and treatment are needed and when they can be avoided.”