Table 2.
Prevalence of keywordsa related to septic patients’ symptom presentation. Prevalence of keywordsa related to septic patients’ symptom presentation, according to EMS documentation, among 359 septic patients arriving by EMS and admitted to Södersjukhuset through the ED during 2013 and in-hospital mortality in relation to these keywords
| Order | Keyworda | Prevalence | In-hospital mortality | ||
|---|---|---|---|---|---|
| Number of total 359 patients | Percent (%) and 95% CI | Number of all patients with the keyword present/ documented | Percent (%) and 95% CI Top-5 highest mortality are numbered1–5 |
||
| 1 | Abnormal, or suspected abnormal temperature | 230 | 64.1 (58.9–69.0) |
48/230 | 20.9 (15.8–26.7) |
|
-Confirmed or suspected fever
Fever defined as statement fever or statement temperature >38°[41] OR suspected fever defined as statement feeling hot/warm, increasing temperature or similar expressions |
210 | 58.5 (53.2–63.6) |
39/210 | 18.6 (13.6–24.5) |
|
| -Shivering | 58 | 16.2 (12.5–20.4) |
6/58 | 10.3 (3.9–21.2) |
|
| -Hypothermia Hypothermia defined as statement hypothermia or “very low temp” or statement temperature <36°[41] |
10 | 2.8 (1.3–5.1) |
8/10 | 80.01
(44.4–97.5) |
|
| 2 |
Pain
Abdominal, extremity, back, undefined, urinary tract, joint, chest, general, headache, throat, wound, painful muscle cramp, positive Pasternatsy’s sign (costovertebral angle tenderness) |
138 | 38.4 (33.4–43.7) |
28/138 | 20.3 (13.9–28.0) |
| 3 |
Acute altered mental status
Abnormal behaviour or level of consciousness (excluding previously known dementia or mental retardation without statement worse) OR abnormal verbal response defined as no/decreased verbal response [25] |
137 | 38.2 (33.1–43.4) |
51/137 | 37.24
(29.1–45.9) |
| 4 | Weakness of the legs | 126 | 35.1 (30.2–40.3) |
27/126 | 21.4 (14.6–29.6) |
| -Decreased ability to stand or walk including need to carry/lift the patient | 98 | 27.3 (22.8–32.2) |
19/98 | 19.4 (12.1–28.6) |
|
| -Fallen/found on the floor or corresponding place | 57 | 15.9 (12.3–20.1) |
13/57 | 22.8 (12.7–35.8) |
|
| 5 | Breathing difficulties | 109 | 30.4 (25.6–35.4) |
39/109 | 35.85
(26.8–45.5) |
| 6 | Loss of energy Defined as fatigue, weakness, faintness or similar expressions |
94 | 26.2 (21.7–31.1) |
24/94 | 25.5 (17.1–35.6) |
| 7 | Gastrointestinal symptoms | 86 | 24.0 (19.6–28.7) |
21/86 | 24.4 (15.8–34.9) |
| -Vomiting | 58 | 16.2 (12.5–20.4) |
11/58 | 19.0 (9.9–31.4) |
|
| -Diarrhoea | 35 | 9.7 (6.9–13.3) |
8/35 | 22.9 (10.4–40.1) |
|
| 8 | Abnormal urination b | 58 | 16.2 (12.5–20.4) |
13/58 | 22.4 (12.5–35.3) |
| -Decreased urinary volumes | 12 | 3.3 (1.7–5.8) |
7/12 | 58.32
(27.7–84.8) |
|
| 9 | Reduced intake of food, fluid or oral medicines | 47 | 13.1 (9.8–17.0) |
18/47 | 38.33
(24.5–53.6) |
| 10 | Nausea | 36 | 10.0 (7.1–13.6) |
5/36 | 13.9 (4.7–29.5) |
| 11 | Malaise Defined as expressions such as feeling sick, feeling bad, not feeling well and similar expressions |
19 | 5.3 (3.2–8.1) |
3/19 | 15.8 (3.4–39.6) |
| 12 |
Mood change
Anxiety or fear OR feeling of depression |
18 | 5.0 (3.0–7.8) |
4/18 | 22.2 (6.4–47.6) |
| 13 | Dizziness | 14 | 3.9 (2.1–6.5) |
1/14 | 7.1 (0.2–33.9) |
| 14 | Fainted but now awake | 10 | 2.8 (1.3–5.1) |
2/10 | 20.0 (2.5–55.6) |
EMS = Emergency Medical Services. CI = Confidence Interval
aPrimary keywords (codes and subcategories derived from the content analysis of septic patients arriving by EMS and admitted to Södersjukhuset during 2012) or combined keywords (consisting of several primary or combined keywords). Combined keywords are bolded, primary keywords are not. For combined keywords, the included primary or combined keywords are presented in descending order beneath the name of the keyword
bAbnormal urination defined as hematuria without trauma, bad smelling or cloudy urine, increased frequency of urination OR urinary tract pain OR decreased urinary volumes OR dysfunction of urinary catheters defined as obstruction/leakage/problematic urinary catheters including nefrostomias