DOI: 10.18710/vganvn
title: Background data for: Pre-hospital identification of infection focus in sepsis and timely empirical antibiotic therapy in a rural ambulance service: A prospective cohort study

description: This dataset is extracted from an ambulance quality registry of patients with suspected sepsis managed by the ambulance department of the University hospital of Northern Norway. Data was collected from patients with suspected sepsis who were given pre-hospital intravenous antibiotics and transported to hospital by the University of Northern Norways ambulance service from May 2018 to August 2022. The dataset was extracted to conduct a study on whether paramedics with or without assistance of general practitioners are able to identify the infection focus in sepsis patients and administer timely intravenous antibiotic treatment. The dataset contains demographic and clinical data, patient trajectories, treatment given in the prehospital environment, patient status at hospital arrival and at discharge, and 30-day all-cause mortality.
description: Abstract from corresponding article: 
&lt;p&gt;Background:
Early diagnosis and initiation of intravenous antibiotic therapy in patients with sepsis reduce both morbidity and mortality, thus management of sepsis in the pre-hospital setting is likely to affect patient outcomes. A clear description of pre-hospital sepsis management with emphasis on trajectory and identification of source of infection may contribute to timely and more targeted pre-hospital antibiotic therapy. The aim of this study was to investigate whether paramedics with or without assistance of general practitioners are able to identify the infection focus in sepsis patients and administer timely intravenous antibiotic treatment.&lt;/p&gt; 
&lt;p&gt;Methods: 
We conducted a cohort study of patients with suspected sepsis who were given pre-hospital intravenous antibiotics and transported to hospital. The setting was mainly rural with long average distance to hospital. Patients received targeted antibiotic treatment after assessment based on clinical work-up supported by scoring systems. Patients were prospectively included from May 2018 to August 2022. Data were registered in a sepsis management ambulance quality registry. Results are presented as median or absolute values. Chi-square tests were used to compare categorised data of source of infection and presence of general practitioners.&lt;/p&gt;
&lt;p&gt;Results:
The study group consisted of 328 patients. Median age was 76 years (IQR 64, 83) and 30-days all-cause mortality was 10.4 %. Antibiotic treatment was initiated at a median of 44 minutes after arrival of ambulance, and median transportation time from place of incident to hospital was 69 minutes. In cases where a suspected source of infection was determined, hospital discharge papers confirmed the pre-hospital diagnosis of infection focus in 195 cases (79.3 %). The presence of a general practitioner during the pre-hospital assessment increased the rate of correctly identified source of infection from 72.6% to 86.1 % (p=0.009). Concordance between pre-hospital identification of a tentative focus and discharge diagnosis was highest for lower respiratory tract (p=0.02) and urinary tract infections (p=0.03).&lt;/p&gt;
&lt;p&gt;Conclusions:
Ambulance personnel are able to identify focus of infection, and start intravenous antibiotics quickly. This is probably of particular value in areas with long transportation times. Collaboration with primary care physicians increases level of diagnostic accuracy.&lt;/p&gt;
description: SPSS, 29.0.1.0