Format

Send to

Choose Destination
J Am Geriatr Soc. 2009 Jan;57(1):40-5. doi: 10.1111/j.1532-5415.2008.02094.x.

Real-time identification of serious infection in geriatric patients using clinical information system surveillance.

Author information

1
Department of Emergency Medicine, University of Michigan, Ann Arbor, 48109-5303, USA. wmeurer@umich.edu

Abstract

OBJECTIVES:

To develop and characterize an automated syndromic surveillance mechanism for early identification of older emergency department (ED) patients with possible life-threatening infection.

DESIGN:

Prospective, consecutive-enrollment, single-site observational study.

SETTING:

A large university medical center with an annual ED census of 75,273.

PARTICIPANTS:

Patients aged 70 and older admitted to the ED and having two or more systemic inflammatory response syndrome (SIRS) criteria during their ED stay.

MEASUREMENTS:

A search algorithm was developed to screen the census of the ED through its clinical information system. A study coordinator confirmed all patients electronically identified as having a probable infectious explanation for their visit.

RESULTS:

Infection accounted for 28% of ED and 34% of final hospital diagnoses. Identification using the software tool alone carried a 1.63 relative risk of infection (95% confidence interval CI51.09-2.44) compared with other ED patients sufficiently ill to require admission. Follow-up confirmation by a study coordinator increased the risk to 3.06 (95% CI52.11-4.44). The sensitivity of the strategy overall wasmodest (14%), but patients identified were likely to have an infectious diagnosis (specificity 598%). The most common SIRS criterion triggering the electronic notification was the combination of tachycardia and tachypnea.

CONCLUSION:

A simple clinical informatics algorithm can detect infection in elderly patients in real time with high specificity. The utility of this tool for research and clinical care may be substantial.

[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley Icon for MLibrary (Deep Blue)
Loading ...
Support Center