Risk Stratification in Sepsis: What We Can Do in the Emergency Room?

Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection and it is an important global health problem. After the Sepsis 3 definition, sepsis is only the tip of the iceberg. Only when is life-threatening, an infection is declared sepsis, so the rapid medical intervention is paramount. As the sepsis is a so important medical condition in daily clinical practice, many scores and biomarkers were studied in order to have a better risk stratification in early phases of an infection. By design, some scores were intended to be used in Emergency Departments (ED), Intensive Care Units (ICU), or in specific wards.

Ideally, the intervention should take place as rapid and earlier as possible. A possible research direction should be based on a rapidly, low-resources, none or minimum equipment requested for measuring parameters for determining a EWS (increased sensitivity) used with a biomarker (rapidly determined) for gaining specificity in order to buy time, further used to reduce the length of stay in ICU and mortality. Verified and revised scores as NEWS2 and biomarkers such as procalcitonin and presepsin offer a research direction to be explored.