B-245 Effect of early-stage protocolized implementation of a novel host-response test on discharges, hospital free days, and returns at four eds in a health system
Abstract
There is a major unmet need in emergency departments for diagnostics that aid in rapid sepsis risk assessment of potentially infected patients [1-3]. In this study, we evaluated the results of implementation of a novel host response test (HR) as part of the protocolized screening and guideline-directed treatment pathway process for patients at risk of sepsis, in four geographically distinct EDs within a health system.
The HR test, which generates an Index based on the state of immune activation stratified into 3 interpretation bands (Band 1- 3) of increasing sepsis likelihood [4], was integrated into the protocolized response to suspected infection at four EDs in Baton Rouge, LA (S1, 9/24/2024 :1/24/2025), Lafayette, LA (S2, 9/24/2024 :1/24/2025), (Jackson, MS (S3, 8/27:12/27/2024) and Monroe, LA (S4, 8/27: 12/27/2024). At all sites, screening and ordering was achieved through 2 mechanisms, a triage-based nurse-driven protocol, and a later physician-driven protocol. Guideline-directed treatment pathways based on the results of the HR test were adopted by the health system.
Patients with missing data for discharge disposition were omitted from this analysis. ED returns were ruled as those who had an ED encounter within 30 days of their original encounter, excluding encounters with discharge ICD-10 diagnosis codes related to mental health (F1-99), substance abuse (F10-19), chronic pain (G89), sickle cell disease (D57), end of life care (Z51.5), injury/poisoning (S1-99,T1-88),…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 4,650 participants or records.
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