In a recent question to QNet, my question was related to this question of organ failure. My question was : " If there is physician documentation that elevated lactate is due to pancreatitis, is this excluded as a criteria for severe sepsis?" Their answer was: " Yes, if the elevated lactate is considered due to a chronic condition, it may be excluded as evidence of organ dysfunction."
-----Original Message----- From: Sepsisgroups [mailto:[email protected]] On Behalf Of [email protected] Sent: Wednesday, April 20, 2016 12:14 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 201, Issue 3 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Acute on Chronic conditions (Zhukov, Marina (Tacoma)) (Jennifer L Halligan [SJGH]) ---------------------------------------------------------------------- Message: 1 Date: Tue, 19 Apr 2016 14:21:19 +0000 From: "Jennifer L Halligan [SJGH]" <[email protected]> To: "[email protected]" <[email protected]>, "[email protected]" <[email protected]> Subject: [Sepsis Groups] Acute on Chronic conditions (Zhukov, Marina (Tacoma)) Message-ID: <[email protected]> Content-Type: text/plain; charset="us-ascii" Hi Marina, Recently I asked QNET this question. The answer was (for the organ dysfunction criteria for SEP-1), it is ACUTE organ dysfunction that is acceptable to use as organ dysfunction criteria. Chronic conditions, i.e. ESRD, Heart Failure or medication, or any CHRONIC condition causing the organ dysfunction can be excluded. It would be advisable that there is physician documentation supporting this. Acute on Chronic organ dysfunction is still considered ACUTE and IS acceptable. For example AKI on CKD can be acceptable, and also ACUTE HF exacerbation on top on Chronic HF is acceptable. It also appears that ANY acute organ dysfunction (i.e. even if not related to the infection) will be acceptable meet criteria of SEP-1 organ dysfunction. For example, if patient has Cardiogenic Shock as the principle DX with an elevated CR and lactic acidosis (with physician documentation stating the CR>2 and lactic acidosis (LA > 2) is caused from the Cardiogenic shock) but the pt also has and elevate d WBC, tachycardia and Cellultitis of LE, the CR>2 and LA>2 would still be acceptable to abstract as organ dysfunction for purposes of this measure. "Sepsis" plus ACUTE organ dysfunction qualifies for the Bundle. Hope that helps. If you want to see the QNET response let me know. Jennifer ________________________________________ From: Sepsisgroups [[email protected]] on behalf of [email protected] [[email protected]] Sent: Monday, April 18, 2016 3:17 PM To: [email protected] Subject: Sepsisgroups Digest, Vol 201, Issue 1 Send Sepsisgroups mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org or, via email, send a message with subject or body 'help' to [email protected] You can reach the person managing the list at [email protected] When replying, please edit your Subject line so it is more specific than "Re: Contents of Sepsisgroups digest..." Today's Topics: 1. Acute on Chronic conditions (Zhukov, Marina (Tacoma)) ---------------------------------------------------------------------- Message: 1 Date: Wed, 13 Apr 2016 22:07:44 +0000 From: "Zhukov, Marina (Tacoma)" <[email protected]> To: "[email protected]" <[email protected]> Subject: [Sepsis Groups] Acute on Chronic conditions Message-ID: <a52d287479316c47a84ef7d5dc03699ec96ee...@chiex007.chi.catholichealth.net> Content-Type: text/plain; charset="us-ascii" We are struggling with defining Organ dysfunction criteria for acute on chronic conditions. What everyone else is doing to separate Acute on Chronic renal failure with chronically elevated Creatinine? Is it considered to be related to sepsis presentation with acute Cr=10.0 or chronic baseline of Cr= 3.2. Where is that fine line of 'yes/no'? Thanks, Marina Zhukov, RN, BSN Clinical Data Abstractor Franciscan Administrative Center-Market 1149 Market Street, Tacoma, WA 98402 | MS 10-04 P. 253.552.5782 | I. 152-5782 [email protected]<mailto:[email protected]> www.CHIfranciscan.org<http://www.chifranciscan.org/> [http://emailopen.com/mmimages1/client_1058/wywimages_cl1058_ca37928/chi_fh_png250.png] [http://emailopen.com/mmimages1/client_1058/wywimages_cl1058_ca37928/fb%20icon.png] <https://www.facebook.com/FranciscanHealth> [http://emailopen.com/mmimages1/client_1058/wywimages_cl1058_ca37928/twitter%20icon.png] <https://twitter.com/FHSHealth> [http://emailopen.com/mmimages1/client_1058/wywimages_cl1058_ca37928/youtube%20icon.jpg] <https://www.youtube.com/user/Franciscanhealth> This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. 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