OR
Two of the above organ dysfunction criteria
Study design
The study included a prospective consecutive series of all adult patients presenting to the ED from Oct. 1, 2012 to Jan. 31, 2013. We considered the clinical assessment of the emergency and ICU physicians to be the reference standard. ED and ICU physicians assessed patients for the presence of severe sepsis or septic shock using the standard diagnostic criteria [6]. The assessment was independent from the electronic sepsis alert system. The study excluded patients younger than 14 years of age, which is the cutoff in our hospital for adult patients. The study was approved by the National Guard Health Affairs (NGHA) Institutional Review Board (IRB) and no consent was required.