TABLE 2.
PRE-HOSPITAL CHARACTERISTICS OF SEVERE SEPSIS HOSPITALIZATIONS IN 2009, COMPARING BY DIAGNOSIS ON ADMISSION
| Variable | All Hospitalizations with Severe Sepsis (n = 2,305) | Severe Sepsis Diagnosed on Admission (n = 1,844) | Severe Sepsis Not Diagnosed on Admission (n = 461) | P Value* |
| Age, yr: mean (SD) | 72 (15) | 73 (15) | 69 (17) | <0.01 |
| Female sex, no. (%) | 1,184 (52) | 951 (52) | 233 (51) | 0.72 |
| Level of EMS care, no. (%) | ||||
| ALS + BLS | 1,118 (48) | 908 (49) | 210 (46) | 0.16 |
| BLS only | 1,187 (52) | 936 (51) | 251 (54) | |
| EMS severity, no (%)† | ||||
| Life-threatening | 67 (17) | 56 (18) | 11 (18) | 0.54 |
| Urgent | 197 (52) | 160 (51) | 37 (58) | |
| Nonurgent | 115 (30) | 99 (31) | 16 (25) | |
| Pre-hospital time interval, min: mean (SD) | ||||
| Responding to scene time | 6.2 (3.7) | 6.1 (3.4) | 6.6 (4.8) | <0.01 |
| Total scene time | 32.8 (17.1) | 33.2 (17.2) | 31.1 (16.5) | 0.02 |
| Scene-to-hospital time | 12.7 (10.5) | 12.4 (10.1) | 14.4 (12.0) | 0.01 |
| Abnormal pre-hospital vital signs, no. (%) | ||||
| Systolic blood pressure ≤ 90 mm Hg | 477 (22) | 408 (23) | 69 (17) | <0.01 |
| Respiratory rate > 36 breaths/min | 227 (11) | 192 (11) | 35 (8) | 0.07 |
| Glasgow Coma Scale score ≤ 11 | 382 (12) | 248 (13) | 34 (7) | <0.01 |
| SaO2 < 88% | 344 (15) | 294 (16) | 50 (11) | <0.01 |
| Heart rate ≥ 120 beats/min | 448 (20) | 374 (21) | 74 (17) | 0.04 |
| Pre-hospital critical illness risk score, mean (SD) ‡ | 2.28 (1.34) | 2.36 (1.38) | 1.95 (1.11) | <0.01 |
| Pre-hospital procedures, no. (%) | ||||
| Supplemental oxygen | 1,518 (66) | 1,235 (67) | 283 (61) | 0.03 |
| Bag valve mask ventilation | 191 (8) | 167 (9) | 24 (5) | <0.01 |
| ECG monitoring | 1,047 (45) | 856 (46) | 191 (41) | 0.05 |
| Endotracheal intubation | 252 (11) | 224 (12) | 28 (6) | <0.01 |
| Peripheral intravenous access§ | 720 (31) | 596 (32) | 124 (27) | 0.03 |
Definition of abbreviations: ALS = advanced life support; BLS = basic life support; EMS = emergency medical services; SaO2 = arterial oxygen saturation.
*
Comparing diagnosed on admission versus not diagnosed on admission; parametric or nonparametric test, as appropriate.
†
Determined by first arriving EMS personnel.
‡
Calculated as an integer score ranging from 0 to 8, using a previously published risk model (20).
§
Peripheral intravenous access does not include placement of central or intraosseous catheters.