SHM Converge Scientific Abstract ePoster Gallery-Ed Boarders With Sepsis Experience Delays in Care

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This retrospective cohort study examined whether emergency department (ED) boarding affects sepsis care and mortality in patients with community-acquired severe sepsis who met “time zero” (T-0) within 48 hours of admission. The study included patients admitted to a large academic hospital from July 2021 to September 2023 and compared those under active ED care with those boarding in the ED.<br /><br />The primary outcome was compliance with the SEP-1 sepsis bundle. Secondary outcomes included compliance with individual SEP-1 elements and in-hospital mortality. Analyses also adjusted for age, heart failure, kidney disease, and shock.<br /><br />Among all patients, ED boarders had lower SEP-1 compliance than patients receiving ED care (24% vs 41%). They were less likely to receive fluid resuscitation (17% vs 30%) and lactate testing (58% vs 95%). In a subgroup of patients who met T-0 while still boarding, SEP-1 compliance was again lower (21% vs 42%), with especially low fluid resuscitation (5.9% vs 29%), lower lactate collection (71% vs 96%), and lower blood culture collection (74% vs 86%). Antibiotic compliance was also somewhat lower in this subgroup, and time to antibiotics was longer for boarders (144 vs 83 minutes).<br /><br />After adjustment, ED boarding remained strongly associated with lower SEP-1 compliance (adjusted odds ratio 0.42, 95% CI 0.31–0.57). However, boarding was not associated with increased in-hospital mortality (16% vs 16% overall; adjusted odds ratio 0.95, 95% CI 0.66–1.34).<br /><br />Overall, the study found that ED boarding is linked to delays and reduced adherence to key sepsis bundle components, but not to a detectable difference in hospital mortality.

Asset Subtitle

Julieann Grant

Meta Tag

Author List David Paje, Jessica Blank, Jessie King, Julieann Grant, Sachita Shrestha, Shuo Tian, Stephanie Taylor

Category Research

Concept Emergency Department Boarding

Concept Sepsis

Concept SEP-1 Sepsis Bundle

Concept Antibiotic Timing

Concept Community-Acquired Sepsis

Distinguished Finalist

Presenter Organization University of Michigan

Presenting Author Julieann Grant

Track Outcomes Research

Keywords

emergency department boarding

sepsis care

community-acquired severe sepsis

SEP-1 bundle

mortality

lactate testing

fluid resuscitation

antibiotic timing

retrospective cohort study

hospital admission

Emergency Department Boarding

Sepsis

SEP-1 Sepsis Bundle

Antibiotic Timing

Community-Acquired Sepsis