Abstract：
BACKGROUND: Up to 11% of critically ill patients with sepsis have an unknown source, where the pathogen and site of infection are unclear. The aim of this scoping review is to document currently reported diagnostic criteria of sepsis of unknown origin (SUO) and identify the types and breadth of existing evidence supporting diagnostic processes to identify the infection source in critically ill patients with suspected SUO.
METHODS: A literature search of Embase, MEDLINE and PubMed for published studies from 1910 to August 19, 2021 addressing the topic of SUO was performed. Study type, country of origin according to World Bank classification, diagnostic criteria of sepsis of unknown origin, and investigative approaches were extracted from the studies.
RESULTS: From an initial 722 studies, 89 unique publications fulfilled the inclusion and exclusion criteria and were included for full text review. The most common publication type was case report/series 45/89 (51%). Only 10/89 (11%) of studies provided a diagnostic criteria of SUO, but a universally accepted diagnostic criterion was not identified. The included studies discussed 30/89 (34%) history, 23/89 (26%) examination, 57/89 (64%) imaging, microbiology 39/89 (44%), and special tests 32/89 (36%) as part of the diagnostic processes in patients with SUO.
CONCLUSIONS: Universally accepted diagnostic criteria for SUO was not found. Prospective studies on investigative processes in critically ill patients managed as SUO across different healthcare settings are needed to understand the epidemiology and inform the diagnostic criteria required to diagnose SUO.
METHODS: A literature search of Embase, MEDLINE and PubMed for published studies from 1910 to August 19, 2021 addressing the topic of SUO was performed. Study type, country of origin according to World Bank classification, diagnostic criteria of sepsis of unknown origin, and investigative approaches were extracted from the studies.
RESULTS: From an initial 722 studies, 89 unique publications fulfilled the inclusion and exclusion criteria and were included for full text review. The most common publication type was case report/series 45/89 (51%). Only 10/89 (11%) of studies provided a diagnostic criteria of SUO, but a universally accepted diagnostic criterion was not identified. The included studies discussed 30/89 (34%) history, 23/89 (26%) examination, 57/89 (64%) imaging, microbiology 39/89 (44%), and special tests 32/89 (36%) as part of the diagnostic processes in patients with SUO.
CONCLUSIONS: Universally accepted diagnostic criteria for SUO was not found. Prospective studies on investigative processes in critically ill patients managed as SUO across different healthcare settings are needed to understand the epidemiology and inform the diagnostic criteria required to diagnose SUO.
摘要：
背景：高达11%的脓毒症危重患者来源不明，病原体和感染部位不清楚。本范围审查的目的是记录目前报道的不明原因脓毒症（SUO）的诊断标准，并确定支持诊断过程的现有证据的类型和广度，以确定可疑SUO的危重患者的感染源。
方法：Embase的文献检索，MEDLINE和PubMed进行了1910年至2021年8月19日发表的针对SUO主题的研究。研究类型,根据世界银行分类的原产地，不明原因脓毒症的诊断标准,并从研究中提取了调查方法。
结果：从最初的722项研究来看，89种独特的出版物符合纳入和排除标准，并被纳入全文审查。最常见的出版物类型是病例报告/系列45/89（51％）。只有10/89(11%)的研究提供了SUO的诊断标准，但尚未确定普遍接受的诊断标准.纳入的研究讨论了30/89(34%)的历史，23/89（26%）检查，57/89（64%）成像，微生物学39/89（44%），和特殊测试32/89（36％）作为SUO患者诊断过程的一部分。
结论：没有发现普遍接受的SUO诊断标准。需要对不同医疗机构中作为SUO管理的危重患者的调查过程进行前瞻性研究，以了解流行病学并告知诊断SUO所需的诊断标准。
方法：Embase的文献检索，MEDLINE和PubMed进行了1910年至2021年8月19日发表的针对SUO主题的研究。研究类型,根据世界银行分类的原产地，不明原因脓毒症的诊断标准,并从研究中提取了调查方法。
结果：从最初的722项研究来看，89种独特的出版物符合纳入和排除标准，并被纳入全文审查。最常见的出版物类型是病例报告/系列45/89（51％）。只有10/89(11%)的研究提供了SUO的诊断标准，但尚未确定普遍接受的诊断标准.纳入的研究讨论了30/89(34%)的历史，23/89（26%）检查，57/89（64%）成像，微生物学39/89（44%），和特殊测试32/89（36％）作为SUO患者诊断过程的一部分。
结论：没有发现普遍接受的SUO诊断标准。需要对不同医疗机构中作为SUO管理的危重患者的调查过程进行前瞻性研究，以了解流行病学并告知诊断SUO所需的诊断标准。
