Optimizing early surgical sepsis management in the emergency department: Risk factors, early detection, and management: A scoping review.

BACKGROUND

This scoping review aims to evaluate the current literature on early sepsis management for surgical patients presenting to the emergency department (ED), with a focus on predisposing risk factors, early diagnostics, and timing of management to determine best practices for optimizing outcomes.

METHODS

A structured literature review was conducted using PubMed, EMBASE, ProQuest, Cochrane, and Google Scholar to identify relevant studies on sepsis in surgical patients, including those with traumatic injuries, presenting to the ED. Eligible studies investigated adult patients (≥18 years) with sepsis or suspected sepsis, reporting on risk factors, diagnostic tools, or timing of management.

RESULTS

Out of 1155 studies identified, 18 met the inclusion criteria, comprising 14 retrospective and 4 prospective cohort studies. Independent risk factors for surgical patients developing sepsis included older age (OR 1.01, P < 0.001), male gender (P < 0.001), and having comorbidities such as diabetes (OR 1.2, P = 0.005). Elevated biomarkers like C5a and lactate were significantly associated with sepsis severity. Early initiation of sepsis management was associated with a significantly lower mortality risk compared to delayed treatment.

CONCLUSION

This review identified several modifiable and non-modifiable risk factors relevant to sepsis prediction in surgical ED patients, as well as diagnostic tools tailored to this population. Early detection and timely initiation of sepsis management are crucial to reducing mortality and improving outcomes. Further research is needed to refine sepsis care in the ED.