Nearly half of patients admitted for suspected sepsis do not meet sepsis criteria

Patients admitted to hospital with suspected sepsis do not always turn out to have the condition. A retrospective observational study at an adult tertiary hospital emergency department identified 595 patients admitted with suspected sepsis and reclassified them using standardised objective criteria. Only 267 patients, or 45%, met the criteria for sepsis, while 210 patients, or 35%, were classified as having infection without sepsis, 58 patients, or 10%, had septic shock, and 60 patients, or 10%, received a non-infective primary diagnosis.

Structured sepsis screening and management tools are associated with improvements in processes of care, but evaluating their effects on clinical outcomes is difficult because screening may capture a broader group of patients with less severe illness.

Rates of organ support, intensive care admission, and mortality varied significantly between groups, reflecting the wide range of illness severity captured when patients are admitted under a suspected sepsis pathway.

The authors conclude that an emergency department sepsis screening program identifies a range of patients, with 45% not meeting clinical sepsis criteria. They argue that measuring the effectiveness of sepsis recognition tools on clinical outcomes requires standardised confirmation of sepsis, in order to inform quality-of-care measures, benchmarking, and resource allocation. Because the study was a single-centre retrospective analysis, the findings describe one tertiary hospital’s admitted population and the reported proportions may not generalise to other settings.

Subject of Research: Incidence of confirmed sepsis and outcomes among emergency department patients admitted for suspected sepsis

Article Title: Characteristics and outcomes of patients admitted for suspected sepsis

Article References: Dempsey, C., Burcham, J., Damianopoulos, S., & Macdonald, S. (2026). Characteristics and outcomes of patients admitted for suspected sepsis. BMC Emergency Medicine. https://doi.org/10.1186/s12873-026-01809-z

Image Credits: AI Generated

DOI: 10.1186/s12873-026-01809-z

Keywords: sepsis, septic shock, emergency department, sepsis screening, retrospective study, mortality, organ support, intensive care, infection, patient outcomes, Characteristics, outcomes