Sepsis Advisor: a clinical decision support tool to help predict and prevent future unexpected deterioration of patients with infection

Critical care is at the forefront of the COVID-19 challenge, and there is a need to identify those patients presenting to the Emergency Department (ED) at highest risk of deterioration in order to optimize disposition. Patients admitted to the ward who then deteriorate, requiring ICU admission, have worse outcomes and increased total costs, compared to patients admitted directly to the ICU from the ED. Based on data from 832 ED patients presenting with infection at 2 centres, we developed a novel tool, Sepsis Advisor (SA), to provide disposition clinical decision support to physicians assessing patients with infection in the ED. Please See: Heart Rate Variability, Clinical and Laboratory Measures to Predict Future Deterioration in Patients Presenting With Sepsis. The predictive model was generated by using heart rate variability (HRV) combined with laboratory data, in order to identify high-risk patients with an increased risk of deterioration, and low-risk patients with a decreased risk of deterioration. This information can assist ED clinicians in optimizing patient disposition. In an observational, mixed-methods Phase 1 feasibility study, we recently assessed the feasibility and the initial perception of introducing, Sepsis Advisor into the Emergency Department at both the Civic Campus and General Campus of The Ottawa Hospital. Sepsis Advisor will help improve the quality and efficiency of care for patients with suspected COVID-19 infection, optimize disposition from ED to ensure best clinical outcomes are achieved, and minimize unexpected deterioration at home or on the ward requiring harmful, resource-intensive, and costly ICU transfer.