gms | German Medical Science

Background and state of research: Sepsis is a life-threatening organ-dysfunction due to infection. Patients are important agents in prevention and early recognition of sepsis. There is a paucity of studies on sepsis knowledge among groups with increased risk for sepsis-related death and morbidity [1]. The ability to use this knowledge to recognize sepsis as an emergency has not yet been studied.

Research question and aim, hypothesis: We aimed to investigate a) sepsis knowledge and b) the ability to identify sepsis as a medical emergency, as well as c) influencing factors among specific risk groups for sepsis.

Methods: Study design: cross-sectional survey conducted as the baseline measure of the evaluation of the “Sepsis-Wissen” health campaign (https://www.sepsiswissen.de/).

Sample: convenience sample of a) elderly persons (>= 60 years) recruited via a consumer panel, and b) adult patients with chronic diseases (e.g. diabetes, cancer) recruited via self-help groups, general practitioners, or social media.

Procedure: conduction of standardized survey online, via telephone or face-to-face.

Questionnaire: mostly used pre-existing validated scales or items adapted to the study question (sepsis knowledge, health literacy, health information seeking behavior). Ability to detect sepsis as an emergency (“sepsis emergency response”) was assessed via five case vignettes describing acute situations and asking if patients would search emergency care, visit their family physician, or wait. In addition, case vignettes assessed, how patients rated non-sepsis medical situations (“urgency rating” of five emergencies, five non-emergencies).

Analyses: descriptive statistics and multiple linear regressions to predict sepsis knowledge and the sepsis emergency response.

Results: On average, the 740 participants answered 45.4% of the 36 items on sepsis knowledge correctly. Most patients knew that sepsis is a serious defensive reaction caused by infection (75.9%), but only 30.8% knew that vaccination prevents infections leading to sepsis. On average, participants identified sepsis as an emergency in only 1.33 of five case vignettes. Sepsis knowledge was higher given participants were older, were of female gender, highly educated, and reported more extensive health information seeking behavior. The sepsis emergency response was higher among younger patients without chronic disease, and with higher health literacy. Interestingly, while sepsis knowledge was no significant predictor, the urgency rating for other medical situations was the strongest significant predictor.

Discussion: It is alarming that patients of defined risk-group for sepsis know little about the preventive importance of vaccination and are not able to identify sepsis as a medical emergency. Knowledge of the disease was not sufficient to trigger an emergency response to sepsis.

Implication for health services: Health campaigns for sepsis need to address specific knowledge gaps especially among persons with low education and infrequent health information seeking. Better strategies need to be found to transfer knowledge in appropriate action in medical emergencies and to decrease barriers to seeking emergency care.

Funding: Innovationsfonds/Versorgungsforschung; 01VSF19020