In Brief | Infectious Diseases | Sepsis
Impact of Electronic Sepsis Screening on In-Hospital Mortality: Insights from a Stepped-Wedge Cluster Randomized Trial
Time to read: 03: 02
Time to listen: 04:54
Originally Published: 10 December 2024
Sourced: JAMA
Type of article: In Brief
MedED Catalogue Reference: MIBID0016
Category: Infectious Diseases
Cross Reference: Critical Care
Keywords: qSOFA-Based Sepsis Screening, Sepsis, Mortality, vasopressor therapy, kidney replacement therapy, multidrug-resistant organisms
Implementing electronic sepsis screening using the quick Sequential Organ Failure Assessment (qSOFA) score in hospital wards was associated with reduced 90-day in-hospital mortality.
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This is a review of original research published in JAMA, 10 December 2025. This article does not represent the original research, nor is it intended to replace the original research. Unless otherwise references, all information contained in this review is referenced to the original work. Access the full Disclaimer Information.
In Context
This study aimed to evaluate the impact of electronic sepsis screening using the quick Sequential Organ Failure Assessment (qSOFA) score on in-hospital mortality.
Study Purpose
Study Methodology
Findings
Patients were divided into two groups: 29,442 received electronic sepsis screening, while 30,613 did not.
The median age was 59 years (interquartile range: 39-68), with males comprising 51% of the study population.
The following findings were recorded:
Alerts were triggered in 14.6% of patients in the screening group and 17.6% in the no-screening group.
Within 12 hours of an alert, patients in the screening group were more likely to undergo serum lactate testing (adjusted relative risk [aRR], 1.30; 95% CI, 1.16-1.45) and receive intravenous fluids (aRR, 2.17; 95% CI, 1.92-2.46) compared to those without screening.
Additionally, screening reduced the need for vasopressor therapy and decreased the incidence of multidrug-resistant organisms. However, it was associated with increases in code blue activations and incident kidney replacement therapy.
Clinical Implications
The implementation of electronic sepsis screening led to increased early interventions, such as serum lactate measurements and intravenous fluid administration within the first 12 hours of alert activation.
These timely responses are crucial in sepsis management and likely contributed to the observed reduction in mortality. Interestingly, the mortality reduction was consistent among patients with and without documented infections, suggesting that the benefits of screening may extend beyond traditional sepsis definitions.
Unintended Consequences
Despite the positive outcomes, the study noted some unintended consequences, including increased rates of code blue activations and incident kidney replacement therapy. These findings highlight the complexity of sepsis management and the need for careful monitoring to balance the benefits of early detection with potential risks associated with increased interventions.
Conclusion
Electronic sepsis screening using qSOFA significantly lowered in-hospital 90-day mortality among ward patients. Despite some increased interventions, the findings support its use as an effective strategy for early sepsis detection and management.
Access the Original Trial
Arabi YM, Alsaawi A, Alzahrani M, et al. Electronic Sepsis Screening Among Patients Admitted to Hospital Wards: A Stepped-Wedge Cluster Randomized Trial. JAMA. 2025;333(9):763–773. doi:10.1001/jama.2024.25982
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