Early detection of sepsis at the out-of-hours GP Cooperative; TeSD-IT study completed

Can we support GPs with diagnostics to identify patients with sepsis (serious infection with organ failure) at home more quickly and effectively?

That is the research question [1] of the UMCU, Radboud University and Star-shl, together with the participating out-of-hours GP cooperatives in Ede, Oss, Uden and Den Bosch. Feike Loots (emergency care physician, UMCU) is the PhD candidate in this study. The study was successfully completed despite the COVID-19 pandemic.

What handhold does the GP really have when assessing these patients? And what is the value of biomarkers determined at the point-of-care (POCT)? Our preliminary studies have shown that (timely) recognition of sepsis at home is often very difficult and can have negative consequences for the patient and the caregiver [2-5].

367 patients with severe infections participated. They had been visited at home by the general practitioner on duty from the out-of-hours GP cooperative. Three expert panels with intensivists, infectious disease specialists and general practitioners assessed retrospectively, and based on all available medical information, whether sepsis was present according to accepted criteria and general opinion. This proved to be the case in no fewer than 40% of them. As far as we know, no GP study this large has ever been conducted with so many seriously ill people.

We now know which combination of factors from the consultation with the patient contributes most to the diagnosis of sepsis. The statistical analyses have been completed. Because the results will first be discussed within the project group, we will keep the news to ourselves for the time being. We will be able to report much more on this in the first quarter of 2021. So, please be patient a bit longer.