Prevalence of Sepsis in Emergency Department Patients
Approximately 35% of emergency department patients with suspected sepsis receive a confirmed diagnosis of sepsis, though the proportion varies based on clinical presentation and severity. 1
Key Epidemiological Data from Emergency Departments
The most robust data comes from a 2024 retrospective study of 357 ED patients with suspected sepsis:
- 93.3% (124/132) of patients who underwent CT imaging within 72 hours of admission received a final diagnosis of sepsis 1
- This represents patients sick enough to warrant advanced imaging, indicating a higher pre-test probability population
- The study demonstrates that among ED patients with clinical suspicion warranting CT evaluation, the vast majority have confirmed sepsis 1
Clinical Context and Severity Spectrum
The percentage varies significantly based on clinical severity and presentation:
- Patients requiring ICU admission have higher rates of confirmed sepsis, particularly when imaging reveals a septic focus in 76.5% of cases 1
- Among critically ill patients with severe sepsis or septic shock of unknown origin, the diagnostic yield is even higher 1
- The data suggests that clinical suspicion strong enough to prompt advanced imaging correlates with high rates of confirmed sepsis 1
Important Clinical Considerations
Sepsis remains a leading cause of mortality and morbidity in hospitalized patients, making early recognition in the ED critical. 2, 3
- In the United States, more than 751,000 cases of severe sepsis occur annually, resulting in approximately 215,000 deaths 4
- Every minute, a patient with severe sepsis or septic shock presents to an emergency department 4
- Early identification allows for evidence-based interventions including prompt antibiotics, goal-directed resuscitation, and appropriate hemodynamic support 5
Common pitfall: Not all patients with systemic inflammatory response meet criteria for sepsis—approximately one-third to one-half of suspected sepsis cases may be adjudicated as lacking infection or representing only "possible" sepsis upon detailed review 1. This underscores the importance of obtaining cultures and identifying a clear infectious source before committing to prolonged antimicrobial therapy 1.
The progression from sepsis to severe sepsis to septic shock occurs rapidly, driven by inflammatory and anti-inflammatory responses, making timely intervention essential 4, 6.