Sepsis from early detection to survivorship

  1. Macquarie University
  2. Faculty of Medicine, Health and Human Sciences
  3. Departments and schools
  4. Australian Institute of Health Innovation
  5. Our research centres
  6. Health Systems and Safety Research
  7. Our research
  8. Sepsis from early detection to survivorship
Professor Ling Li

Improving sepsis patient care and outcomes

Sepsis research is needed to support clinicians, policymakers and the public – from early detection to survivorship.

A digital graphic of blood cells.

About the project

Sepsis is a medical emergency declared by the World Health Organisation (WHO), and is a leading cause of death, disability and healthcare expenditure worldwide and in Australia.

The Health Analytics and Patient Safety research stream is undertaking a sepsis program, which includes range of projects to support important research into early detection and survivorship.

Project lead: Professor Ling Li

Other members and collaborators
  • Dr Kasun Rathnayake

Research streams

Our sepsis research program is comprised of five main research themes. Read more about each theme and the associated publications below.

1.1 Evaluation and optimisation of risk identification tools for the early detection of sepsis in adult inpatients

This project was funded by the Clinical Excellence Commission and eHealth NSW. The aims of this project were:

  1. to evaluate the performance of three risk identification tools for early detection of sepsis cases in adult inpatients during hospital admissions
  2. to develop two sets of optimised tools applicable at the bedside and for an electronic system. We assessed:
    1. two bedside tools manually calculated by clinical staff (the quick Sepsis-related Organ Failure Assessment (qSOFA) score and the Adult Sepsis Pathway)
    2. one electronic decision support tool embedded in the electronic Medication Record systems (the Modified St. John Rule).

This project was the first to evaluate the Adult Sepsis Pathway and the Modified St. John Rule in New South Wales, and to compare the performance between these two tools and the qSOFA score. We used more than 130,000 patient admissions from 34 healthcare facilities across metropolitan, rural and regional localities to evaluate these tools and explore improved alternatives.

1.2 Clinical decision support for early detection

This project aims to:

  • examine the scope and evidence on the effectiveness of clinical decision support systems (CDSS) to support sepsis early detection
  • investigate the effectiveness of CDSS using the electronic health record data.

We have published three review papers and conducted two original research on this research topic.

1.3 Clinical sepsis early detection tools

This project aims to examine the evidence on the effectiveness of clinical score tools for early sepsis detection. In addition to the research conducted by our teams, a number of students in the Macquarie Medical Doctor (MD) program have undertaken research projects in sepsis early detection clinical score supervised by Professor Ling Li. In particular, two MD students have published their first research papers in leading medical journals.

Publications
2.1 Sepsis epidemiology: a nationwide longitudinal investigation

This project was funded by the Australian Commission on Safety and Quality in Health Care (the Commission) as part of the National Sepsis Program.

This project was commissioned as a first step in the Commission’s work to develop a national approach to improving outcomes for patients with sepsis across Australia.

The team produced the first national longitudinal sepsis epidemiology report, led by Professor Ling Li and published by the Commission. This report aimed to

  • determine the incidence and mortality of sepsis in public hospitals
  • investigate variations in incidence and mortality related to patient and hospital stay characteristics
  • investigate sepsis-related practice and initiatives across states/territories.

A mixed-methods longitudinal study was conducted. The study cohort included 24 million hospitalisations from 739 public hospitals in Australia. Semi-structured interviews were conducted with clinicians, patient safety professionals and sepsis researchers nationwide. The report highlighted the substantial number of hospitalisations of patients with sepsis and related inequalities that exist in the Australian population.

2.2 Sepsis surveillance

This project aims to utilise the electronic health record data to establish a benchmark for sepsis incidence and patient care.

Publications

Under this theme, we aim to:

  • investigate the patient care and associated outcomes
  • identify the effective interventions to improve patient outcomes.

There are three main research topics within this theme:

  • 3.1: Sepsis patient care and outcomes
  • 3.2: Antibiotics timing and appropriateness
  • 3.3: Postoperative sepsis.

Data linkage and advanced modelling approaches were used for the cohort studies under this theme. In addition, two MD students are currently working on projects related to postoperative sepsis supervised by Professor Ling Li and her team.

Publications

This project aims to examine the impact of sepsis on survivors and related costs on health systems. Survivors often suffer from ongoing sequelae that continue to impact their health after hospital discharge. This topic is the subject of research by PhD Candidate Khalia Ackermann.

Publications

This project aims to examine the evidence of digital health to support sepsis awareness and education. Research topics under this theme include:

  • sepsis mobile apps and their usages
  • using mobile apps to support MD student education.

Two MD students have undertaken research projects in sepsis care and education supervised by Professor Ling Li.

Publications