Sepsis Post Market Observational Study and Potential Reduction of Time to Antibiotics - Washington University

Study Overview
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Brief Summary
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The purpose of this study is to demonstrate that addition of the Monocyte Width Distribution (MDW) parameter to current standard of care improves a clinician's ability to recognize sepsis in the Emergency Department, resulting in earlier decision to administer antibiotics from time of ED presentation for sepsis patients (simulated primary endpoint), with concomitant reductions in length of stay and in-hospital mortality for those patients (secondary endpoints).

Detailed Description
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The objective of this study is to develop a method for identifying sepsis patients from electronic health records (EHR) based on Sepsis-2 criteria. Sepsis patients will be identified using a Sepsis Definition which includes meeting SIRS score of ≥2 within 12 hours of ED presentation and any microbial testing ordered within 24 hours of ED presentation. The patient will be enrolled if it meets the Sepsis Definition and additional EMR data elements will be extracted to complete case report form. Furthermore, objectives include to confirm the clinical validity and performance of MDW in a control population of sepsis patients where MDW is measured but not reported to physicians. This study is an observational study which will simulate the decision impact of MDW on sepsis identification and patient management

Official Title
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Post Market Observational Study of ESId (MDW Hematology Parameter) for Early Sepsis Detection in the Emergency Department (US Hospitals) and Potential Reduction in Time to Antibiotics - Washington University

Conditions
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Sepsis, Adult Disease, Severe Sepsis, Emergency Department

Intervention / Treatment
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* Diagnostic Test: CBC-DIFF Monocyte Volume Width Distribution (MDW)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All race and ethnicities Presenting to the emergency department with suspicion of infection Whose assessment includes a CBC with differential Meets EMR Sepsis Definition Exclusion Criteria: Pregnancy Prisoners Transfers from other ED Previously enrolled

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 89 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CBC-Diff Monocyte Volume Width Distribution<br>Monocyte Volume Width Distribution (MDW) is part of the CBC with Differential | Diagnostic Test: CBC-DIFF Monocyte Volume Width Distribution (MDW)<br>* MDW measurement will be used to detect sepsis. Results will not be used to manage patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Potential reduction of Time to Antibiotics | Validate MDW's ability to reduce time to first antibiotics ordered by physician (decision to treat)-Simulated | 12 hours after ED presentation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Performance | Validate MDW's ability to identify incidence of patients diagnosed as Sepsis vs Non-Sepsis, including SIRS and milder forms of infection (non-SIRS) meeting Sepsis EMR definition of >=2 SIRS criteria within 12 hours of ED presentation and any microbial testing collected within 24 hours of triage in the ED | 12 hours after ED presentation |