School of Medicine Homepage
Emory University Shield
  • About
    • Our Vision
    • Academic Departments
    • Our Leadership
    • Health Care Partnerships
    • Diversity, Equity, & Inclusion
    • Location
    • Supporting Our People
    • Our Faculty
    • History
    • News
    • Events
    • Contact Us
  • Education
    • Degree and Certificate Programs
    • Academic Departments
    • Residents & Fellows
    • Postdoctoral Training
    • Continuing Medical Education
    • Admissions
    • Cost and Financial Aid
    • Student Resources
  • Research
    • Research Innovation
    • Conducting Research
    • Core Facilities
    • Research Centers
    • Research Training
    • Academic Departments
    • Find a Researcher
    • Research News
  • Clinical Experience
    • Where We Work
    • Caring for a Diverse Population
    • Faculty Clinical Experience
    • Advanced Patient Care
    • Academic Departments
    • Community Learning
  • Giving
  • Directory

Emory Real-time Analytics, Data Science and Decision Support (RADS2) section navigation

  • Clinical Trials
    • Sub link
      ACTIV-6 Trials
    • Sub link
      RECOVER
    • Sub link
      Surgery
    • Sub link
      Radiology Service
    • Sub link
      Vaccine Trial
  • Clinical Decision Support
    • Sub link
      Early Warning and Decompensation
    • Sub link
      Sepsis Prediction
    • Sub link
      Unplanned ED Admission (UEDA)
    • Sub link
      eARDS
  • Clinical Operations
    • Sub link
      COVID-19 Patient Care Dashboard
    • Sub link
      Health Equity Data Sandbox
    • Sub link
      Mechanical Ventilation
    • Sub link
      CRRT
  • Team

Emory University School of Medicine

  • About
    • Sub link
      Our Vision
    • Sub link
      Academic Departments
    • Sub link
      Our Leadership
    • Sub link
      Health Care Partnerships
    • Sub link
      Diversity, Equity, & Inclusion
    • Sub link
      Location
    • Sub link
      Supporting Our People
    • Sub link
      Our Faculty
    • Sub link
      History
    • Sub link
      News
    • Sub link
      Events
    • Sub link
      Contact Us
  • Education
    • Sub link
      Degree and Certificate Programs
    • Sub link
      Academic Departments
    • Sub link
      Residents & Fellows
    • Sub link
      Postdoctoral Training
    • Sub link
      Continuing Medical Education
    • Sub link
      Admissions
    • Sub link
      Cost and Financial Aid
    • Sub link
      Student Resources
  • Research
    • Sub link
      Research Innovation
    • Sub link
      Conducting Research
    • Sub link
      Core Facilities
    • Sub link
      Research Centers
    • Sub link
      Research Training
    • Sub link
      Academic Departments
    • Sub link
      Find a Researcher
    • Sub link
      Research News
  • Clinical Experience
    • Sub link
      Where We Work
    • Sub link
      Caring for a Diverse Population
    • Sub link
      Faculty Clinical Experience
    • Sub link
      Advanced Patient Care
    • Sub link
      Academic Departments
    • Sub link
      Community Learning
  • Giving
  • Directory
  • Home School of Medicine Home
  • Clinical Experience
  • Advanced Patient Care
  • Emory Real-time Analytics, Data Science and Decision Support (RADS2)
  • Emory Real-Time Analytics
  • Sepsis Prediction

Sepsis Prediction

A service from the RADS2 Team

Introduction to the Algorithm

Sepsis is a life-threatening organ dysfunction triggered by dysregulated host immune response to infection. As per CDC, at least 1.7 million adults in United States develop sepsis each year with approximately 270,000 deaths. one in three death in hospital is a patient of sepsis.

Acute changes in Sequential Organ Failure Assessment (SOFA) score helps clinically characterize organ dysfunction as a consequent to the infection. This is characterized as SOFA score change of >=2 in 24 hours. It reflects mortality risk of approximately 10% in hospital population having suspected infection. Suspected or documented infections are other measures help identify sepsis.

 SOFA score is calculated based on the degree of dysfunction of six organ system. The following parameters are used in each organ system to calculate individual score that cumulatively reflects SOFA score.

  1. Respiratory System: PaO2/FiO2 ratio
  2. Coagulation System: Platelet count
  3. Hepatobiliary System (Liver): Bilirubin level
  4. Cardiovascular System: Mean Arterial Pressure (MAP), or requirement of vasopressin administration
  5. Renal System: Creatinine level, or urine output
  6. Central Nervous System: Glasgow Coma Scale score

Application Roadmap

Sepsis is defined as life-threatening organ dysfunction due to infection. Prior to COVID, there were more than 270,000 sepsis deaths annually (ref: CDC). COVID has added substantially to that burden: there have been more than 900 COVID deaths at Emory alone. Timely recognition of progressive organ dysfunction is essential to clinical decision-making that saves lives. Unfortunately, given the overwhelming number of patients and flows of data, the earliest signs of deterioration are easily overlooked.  

A real-time dashboard to calculate a patient’s risk of developing sepsis in the near future using the sepsis-3 definition of: 

  • A 2-point degradation in Sequential  Organ Failure Assessment (SOFA) score 
  • Recent orders of blood cultures, and  
  • Recent orders of new antibiotics 

Design and Implementation

The following diagram shows the flow of information from Cerner clinical events tables and patient information tables to six database views that compute scores used in the dashboard display.

sepsis design


The 6 database views are then combined with person Ids into a single view.  The data from the consolidated view is then cached into a table every 6 hours along with a timestamp. The cached table is referenced to calculate the most recent total SOFA, the minimum total SOFA in the last 24h, and the difference between these. Those patients with a difference of >=2 are displayed in the dashboard. In addition, the dashboard pulls in blood cultures and antibiotics orders which are obtained from the Cerner database using order times. The most recent order time is assigned as tsuspicion. This information is then merged with inpatient information and their current locations.

sepsis data flow


The current implementation is a powerful tool to alert clinicians to unfavorable SOFA scores for inpatients. The RADS2 Team is proposing to add capability to flag such patient records through the dashboard by the clinician. Once flagged, the patient record will be highlighted until his/her SOFA score falls below 2. The clinicians will have the option of adding comments to the patient record each time they view the dashboard. This will ensure that the patient status is kept up-to-date. 
Emory Real-time Analytics, Data Science and Decision Support (RADS2)
  • Clinical Trials
    • ACTIV-6 Trials
    • RECOVER
    • Surgery
    • Radiology Service
    • Vaccine Trial
  • Clinical Decision Support
    • Early Warning and Decompensation
    • Sepsis Prediction
    • Unplanned ED Admission (UEDA)
    • eARDS
  • Clinical Operations
    • COVID-19 Patient Care Dashboard
    • Health Equity Data Sandbox
    • Mechanical Ventilation
    • CRRT
  • Team

Stakeholders

Mary D. Still,
clinical nurse specialist at Emory University Hospital

Mary D. Still

Dr. Craig Coopersmith, MD
Professor, Dept. of Surgery

Dr. Coopersmith is the clinical champion for the Real-time Sepsis Detection System. He is the Director of the Emory Critical Care Center and oversees all ICUs across the Emory Healthcare system.

Dr. Craig Coopersmith

David Murphy MD, PhD
Associate Professor, Department of Medicine

Dr. Murphy is an Assistant Professor of Medicine at Emory University in the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine. He is a physician, researcher, and expert in healthcare quality and patient safety.

David Murphy

Raymund B Dantes, MD
Associate Professor, School of Medicine

Raymund B Dantes

Dr. David Wright, MD, FACEP
Chair of the Department of Emergency Medicine

Dr. Wright has served as interim department chair since August 2018. He started his career at Emory University School of Medicine in 1997 after completing his residency at the University of Cincinnati. He was recruited to be an Emergency Medicine clinician/researcher by the inaugural Department Chair, Dr. Arthur Kellerman

Dr. David Wright
Emory University Homepage

Contact & Location

Emory University School of Medicine
100 Woodruff Circle
Atlanta, GA  30322 USA
  • Contact Us
  • Maps & Directions
  • Careers

Information For

  • Alumni
  • Faculty & Staff
  • Patients
  • Residents & Fellows
  • Students
Support the School of Medicine School of Medicine Intranet
facebook facebook twitter twitter linkedin linkedin instagram instagram youtube youtube
© 2024 Emory University
  • Privacy Policy
  • Emergency Information