Clinical Utility of Biomarkers for Outcomes Prediction in Adults with Suspected Sepsis Presenting to the Emergency Department
Sepsis Research FEAT is pleased to have agreed to help provide PPI (Patient and Public Involvement) in a project from the University of Aberdeen aiming to review the current evidence on the use of sepsis biomarkers that are relevant for the emergency department setting. It focuses on markers that help to identify people who are at risk of becoming seriously ill and have early warning signs for sepsis.
Led by Professor of Health Services Research, Miriam Brazzelli, the project is focusing on the fact that sepsis is a common clinical condition among hospitalized patients and carries a high risk of morbidity and mortality, often requiring supportive treatment in the ICU. Improved outcomes for sepsis depend on timely treatment with antibiotics, fluid resuscitation and source control. Nevertheless, sepsis can be challenging to identify, as people with sepsis may present with non-specific, non-localised clinical features such as general malaise and changes from usual behaviour.
Over the past few decades, several assessment methods have been developed for people who might have sepsis. These are designed to help healthcare professionals to decide if someone has increased risk of severe illness or death so that treatment can be initiated rapidly. These include criteria and severity scores, such as the systemic inflammatory response syndrome (SIRS) criteria, the Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3) criteria, the Sequential Organ Failure Assessment (SOFA) score and the updated National Early Warning Score (NEWS2). As sepsis patients often undergo their first assessment in the emergency department, the quick SOFA (qSOFA) score has also been introduced to facilitate assessment outside the ICU.
In general, these criteria and scores evaluate things such as the patient’s blood pressure, breathing, and heart rate. Patients with higher scores need to be assessed and treated promptly. However, even with these scores, it can still be difficult to determine precisely who are more likely to develop severe symptoms. This is because of the great variability between individuals in the signs and causes of infection, other medical conditions they may have, and how they respond to treatment.
Therefore, it has been suggested that the use of biomarkers would improve rapid identification of septic patients at risk of poor outcomes and help guide treatment. Biomarkers are specific cells, molecules, or genes that appear when a person has a particular health condition and can provide useful information on the condition. In sepsis, biomarkers include traditional ones, such as proteins and cytokines and some that are more novel, such as leukocyte transcriptomic markers and genetic markers. However, the role of these biomarkers in determining severity and prognosis among patients presenting with suspected sepsis, particularly during the initial phase of their presentation to hospital, is unclear.
PPI is likely to be required from two individuals – sepsis patients or family members – towards the end of September 2024 in order to help interpret the results of the project’s review and to help plan dissemination activities.
It would be beneficial if individuals feel at ease listening and reading about project findings, providing feedback, and speaking in front of the research team. To find out more or to express an interest in taking part, contact the team here by emailing [email protected].