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Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?

BACKGROUND: The mnemonic “SEPSIS” (S = Slurred speech or confusion, E = Extreme shivering or muscle pain, fever, P = Passing no urine all day, S = Severe breathlessness, I = It feels like you are going to die, S = Skin mottled or discolored) has been developed by the World Sepsis Day committee, so a...

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Autores principales: Wattanapaiboon, Kanokpit, Banditlerdruk, Sarach, Vattanavanit, Veerapong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354908/
https://www.ncbi.nlm.nih.gov/pubmed/32753915
http://dx.doi.org/10.2147/IDR.S263964
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author Wattanapaiboon, Kanokpit
Banditlerdruk, Sarach
Vattanavanit, Veerapong
author_facet Wattanapaiboon, Kanokpit
Banditlerdruk, Sarach
Vattanavanit, Veerapong
author_sort Wattanapaiboon, Kanokpit
collection PubMed
description BACKGROUND: The mnemonic “SEPSIS” (S = Slurred speech or confusion, E = Extreme shivering or muscle pain, fever, P = Passing no urine all day, S = Severe breathlessness, I = It feels like you are going to die, S = Skin mottled or discolored) has been developed by the World Sepsis Day committee, so as to raise public awareness of the symptomatic presentation of sepsis. However, this mnemonic has not been validated. METHODS: A retrospective, observational, single-center study was performed. All adult septic patients presenting at the emergency department of Songklanagarind Hospital from 2016 to 2019 were included and followed up until either hospital discharge or death. RESULTS: The study included 437 patients, comprising patients with sepsis (n = 250) and those with septic shock (n = 187). Patients presented with symptoms according to the mnemonic as follows: S = 97 (22.2%), E = 240 (54.9%), P = 18 (4.1%), S =181 (41.4%), I = 5 (1.1%), and S = 5 (1.1%). Sixty-five patients (14.9%) did not present with any sepsis-specific symptoms according to the mnemonic. Compared with patients who had at least one mnemonic symptom, a higher proportion of patients without mnemonic symptoms had underlying immunosuppression (24.6% vs 8.3%, P < 0.01) and were diagnosed with intraabdominal infection (38.5% vs 12.1%, P < 0.01). In a multivariable adjusted logistic regression model, vague-presenting symptoms were independently associated with in-hospital mortality (adjusted odds ratio 2.17, 95% confidence interval 1.30−3.61, P = 0.03). CONCLUSION: Two components of the mnemonic “SEPSIS” were rarely reported: it feels like you are going to die and skin mottled or discolored. Using the mnemonic might lead to missed diagnoses, especially in immunosuppression and intraabdominal infection. This mnemonic should be revised for the local context.
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spelling pubmed-73549082020-08-03 Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful? Wattanapaiboon, Kanokpit Banditlerdruk, Sarach Vattanavanit, Veerapong Infect Drug Resist Original Research BACKGROUND: The mnemonic “SEPSIS” (S = Slurred speech or confusion, E = Extreme shivering or muscle pain, fever, P = Passing no urine all day, S = Severe breathlessness, I = It feels like you are going to die, S = Skin mottled or discolored) has been developed by the World Sepsis Day committee, so as to raise public awareness of the symptomatic presentation of sepsis. However, this mnemonic has not been validated. METHODS: A retrospective, observational, single-center study was performed. All adult septic patients presenting at the emergency department of Songklanagarind Hospital from 2016 to 2019 were included and followed up until either hospital discharge or death. RESULTS: The study included 437 patients, comprising patients with sepsis (n = 250) and those with septic shock (n = 187). Patients presented with symptoms according to the mnemonic as follows: S = 97 (22.2%), E = 240 (54.9%), P = 18 (4.1%), S =181 (41.4%), I = 5 (1.1%), and S = 5 (1.1%). Sixty-five patients (14.9%) did not present with any sepsis-specific symptoms according to the mnemonic. Compared with patients who had at least one mnemonic symptom, a higher proportion of patients without mnemonic symptoms had underlying immunosuppression (24.6% vs 8.3%, P < 0.01) and were diagnosed with intraabdominal infection (38.5% vs 12.1%, P < 0.01). In a multivariable adjusted logistic regression model, vague-presenting symptoms were independently associated with in-hospital mortality (adjusted odds ratio 2.17, 95% confidence interval 1.30−3.61, P = 0.03). CONCLUSION: Two components of the mnemonic “SEPSIS” were rarely reported: it feels like you are going to die and skin mottled or discolored. Using the mnemonic might lead to missed diagnoses, especially in immunosuppression and intraabdominal infection. This mnemonic should be revised for the local context. Dove 2020-07-08 /pmc/articles/PMC7354908/ /pubmed/32753915 http://dx.doi.org/10.2147/IDR.S263964 Text en © 2020 Wattanapaiboon et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wattanapaiboon, Kanokpit
Banditlerdruk, Sarach
Vattanavanit, Veerapong
Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title_full Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title_fullStr Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title_full_unstemmed Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title_short Presenting Symptoms in Sepsis: Is the Mnemonic “SEPSIS” Useful?
title_sort presenting symptoms in sepsis: is the mnemonic “sepsis” useful?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354908/
https://www.ncbi.nlm.nih.gov/pubmed/32753915
http://dx.doi.org/10.2147/IDR.S263964
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