Table 2.
Clinical Summary of Septic Patients for Validation Cohort.
| Age (yrs) | Major Comorbidities | Systemic Sx | Localizing Sx | tCFI | Triage SBP (mmHg) | Triage HR (bpm) | Triage Temp (°F) | ICU Dx |
|---|---|---|---|---|---|---|---|---|
| “Likely” Pre-diagnostic Infection Probability | ||||||||
| 27 | IBD, TPN | Fever, weakness | “Generalized” abd. pain, HA | + | 104 | 131 | 101.7 | Chole |
| 27 | Unknown | Unresponsive | Unknown | + | 70 | 88 | 96.4 | Pna |
| 31 | Onc | Fever | SOB | + | 98 | 160 | 105.1 | Pna |
| 44 | Onc | Fever, hypotension | +/− abd. pain | + | 100 | 137 | 97.8 | Uro |
| 46 | ESRD, C. Dif. | Weakness | Diarrhea | + | 146 | 68 | 98.4 | Colitis |
| 51 | ESLD, auto | “Chronic body pain” | Nausea, cough, SOB | + | 95 | 80 | 97.0 | Colitis vs pna |
| 53 | Major disability | Unresponsive | Unknown | + | 90 | 97 | 98.7 | Uro |
| 54 | Onc | Weakness | Difficulty swallowing, cough | + | 180 | 113 | 98.5 | Pna |
| 55 | ESLD | Somnolent | Leg pain, bilateral leg edema | + | 108 | 65 | 97.0 | Soft tissue |
| 58 | Onc | Fever, tachycardia | None | + | 124 | 159 | 104.0 | Uro vs chole |
| 59 | Major disability | Fever | SOB | + | 125 | 122 | 97.3 | Uro |
| 65 | Major disability | Fever | Dry mouth, shoulder pain | + | 123 | 88 | 100.2 | Pna vs uro |
| 65 | COPD, CHF, C. Dif. | Lethargy | Abd. pain, diarrhea | + | 88 | 110 | 97.0 | Uro |
| 66 | Unknown | Unknown | SOB | + | 149 | 120 | 96.0 | Pna |
| 66 | Major disability | Fever, lethargy | SOB | + | 160 | 112 | 98.4 | Pna vs uro |
| 67 | Unknown | Unresponsive | SOB | + | 73 | 82 | 98.0 | Pna & endo |
| 71 | None | Fever | Acute femur fx after fall | + | 101 | 83 | 98.0 | Uro |
| 81 | COPD, CAD | Confusion | Abd. pain, SOB | + | 101 | 79 | 98.2 | Peritonitis |
| 85 | Major disability | Fever, lethargy | Unknown | + | 130 | 103 | 100.1 | Uro |
| 89 | COPD | Respiratory arrest | Unknown | + | 87 | 114 | 94.6 | Pna |
| 94 | CHF | Fever | Cough | + | 120 | 70 | 97.2 | Pna |
| “Possible” Pre-diagnostic Infection Probability | ||||||||
| 27 | None | Near-syncope | Breast pain & erythema, SOB | Neg | 87 | 144 | 99.9 | Mastitis |
| 38 | ESLD | Lethargy, confusion | “Mild” abd. pain | + | 190 | 69 | 98.0 | Chole |
| 43 | None (alcoholism) | Somnolent, confused | MODS (from OSH) | Neg | 133 | 109 | 96.5 | Empiric |
| 45 | ESLD | Active seizures | Hypoxia | + | 163 | 144 | 101.7 | Pna |
| 48 | Onc | None | Abd. pain, vomiting, SOB | + | 73 | 72 | 98.2 | Peritonitis |
| 50 | IBD, TPN | Weakness, falls | Abd. pain | + | 98 | 95 | 98.4 | Line |
| 53 | Active cancer, COPD | Weakness | Chest & back pain | + | 143 | 107 | 100.0 | Empiric |
| 54 | Major disability | Fever, confusion | Orthopedic cast (foot) pain | + | 109 | 118 | 102.5 | Uro |
| 56 | None (minor CVA) | Confusion, syncope | Chest pain, SOB | Neg | 159 | 81 | 97.0 | Empiric |
| 56 | ESLD | Weakness | Chest pain | + | 58 | 86 | 97.1 | Uro & colitis |
| 57 | Onc | Lethargy, hypotension | Hemoptysis | + | 97 | 116 | 97.4 | Empiric |
| 59 | CHF | Unknown | SOB | + | 126 | 138 | 97.0 | Pna |
| 60 | None (alcoholism) | Hypotensive | Abd. & chest pain, EKG Δ | Neg | 74 | 122 | 98.0 | Odontogenic |
| 64 | ESLD | Somnolent, confused | Unknown | + | 96 | 96 | 97.9 | Colitis vs uro |
| 67 | None | Somnolent, confused | Unknown | + | 77 | 60 | 97.0 | Empiric |
| 67 | None | Lethargy, syncope | Unknown | + | 103 | 68 | 86.3 | Empiric |
| 69 | ESLD | Somnolent, confused | Unknown | + | 67 | 73 | 97.8 | Soft tissue |
| 70 | None | Lethargy, confusion | Incontinence | + | 148 | 110 | 99.4 | Soft tissue |
| 72 | COPD | Lethargy, diaphoretic | Unknown | + | 64 | 42 | 98.0 | Empiric |
| 74 | CHF | None | Back pain, cough, SOB | + | 126 | 80 | 97.8 | Pna |
| 75 | Onc | None | “Mild” RUQ pain, nausea | + | 186 | 89 | 96.0 | Chole |
| 75 | None | Syncope | Nausea | + | 78 | 130 | 97.4 | Uro |
| 77 | Onc | Myalgias | HA, SOB | + | 79 | 71 | 97.0 | Line |
| 79 | Unknown | PEA arrest | Unknown | + | 129 | 116 | 97.5 | Pna |
| 79 | Major disability | Somnolent, confused | Unknown | + | 137 | 105 | 98.2 | Uro |
| 80 | Onc | None | “Diffuse” abd. pain, SOB | + | 159 | 128 | 97.0 | Pna |
| 81 | Appi (recent) | Syncope | Diarrhea, SOB | + | 136 | 65 | 97.1 | Peritonitis |
| 84 | CHF, COPD | Somnolent | SOB | + | 111 | 77 | 96.2 | Pna |
| “Unlikely” Initial Infection Probability | ||||||||
| 82 | None | “Dizziness” | Significant bradycardia | Neg | 128 | 44 | 98.0 | Urosepsis |
Clinical summary of vasopressor-dependent ED septic shock patients from validation cohort. “Unknown” indicates clinical information that ED providers were unable to obtain, e.g., patient confused or mechanically ventilated. Initial infection probability: Categorization of ED provider concern for bacterial infection prior to diagnostic testing (“likely”, “possible” or “unlikely”) based on the ED provider’s documentation. Major comorbidities: Pre-specified sepsis risk factors (see text for details); notable PMHx that was not included in the tCFI “risk factor” criteria is reported in parentheses. Onc = active cancer; major disability = physical or cognitive disability requiring services; COPD = chronic obstructive pulmonary disease; CAD = coronary artery disease; ESLD = end-stage liver disease including cirrhosis; auto = auto-immune disease with immunosuppressive therapy; CHF = congestive heart failure; C. Dif. = recent or active treatment for C. Dif. colitis; h/o CVA = prior cerebrovascular accident; appi (recent) = recent appendicitis with ongoing antibiotic treatment. Systemic sx and Localizing sx: pertinent positives documented in ED provider note. Sx = symptoms; abd. = abdominal; +/− = ED documentation inconsistent; HA = headache; SOB = shortness of breath; fx = fracture; EKG Δ = ST segment elevations on electrocardiogram; RUQ = right upper quadrant of abdomen; MODS (from OSH) = transferred from outside hospital with multiple organ failure. ICU Dx: documented indication for antibiotic treatment following admission to the ICU. Chole = cholesystitis; uro = urosepsis; pna = pneumosepsis; empiric = antibiotics without identified source; line = indwelling vascular catheter infection.