Experiences and Conclusions of the Hungarian Emergency Sepsis Register

Objective: Early recognition is a key step in decreasing morbidity and mortality in sepsis. Like in other European countries an ever growing number of septic patients enter hospitals via emergency departments. Our goal was to assess the number and severity of patients with sepsis, severe sepsis and septic shock attending the Hungarian emergency departments. Methods: Two-hundred and ninety-nine patients were entered into the Hungarian Emergency Sepsis Register, focusing on age, disease severity, monitoring and oxygenation. Application and time of administration of antibiotics, use of biomarkers, i.e. lactate and procalcitonin, disposition of patients were assessed using a web-based electronic questionnaire. Results: Data arriving from twenty emergency departments revealed that with severity of the disease oxygen administration and level of monitoring increased, along with antibiotic administration and use of biomarkers. Time spent in the ED did not differ between septic, severely septic and septic shock patients; however higher level of care was provided for the sickest patients. Conclusion: Our register data indicate that sepsis presents a substantial challenge to Hungarian emergency departments. The set standards for timely, adequate treatment are not yet met. The results are however also influenced by characteristics of the Hungarian health care system, most notably the lack of hospice systems. Further studies are needed to separate the subset of patients who would require and of life care.