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Abstract：
BACKGROUND: Sepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis. Based on this, concrete recommendations for the organization of care and patient information materials will be developed with close patient participation.
METHODS: Mixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques.
CONCLUSIONS: The results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae.
BACKGROUND: Registered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023).
METHODS: Mixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques.
CONCLUSIONS: The results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae.
BACKGROUND: Registered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023).
摘要：
背景：脓毒症与全世界约20%的死亡有关。它通常表现为非特异性的初始症状，使其紧急治疗成为跨学科和跨部门的挑战。四分之三的败血症幸存者患有新的认知，心理,或缺乏特定治疗概念的物理后遗症。AVENIR项目旨在提高对患者路径的理解，以及之前整个医疗保健路径中的主观护理经验和需求，败血症和败血症后。基于此,将在患者密切参与的情况下制定有关组织护理和患者信息材料的具体建议.
方法：混合方法研究，包括（1）分析来自德国的匿名全国健康索赔数据，（2）将健康声明数据与来自德国两个联邦州研究地区的紧急医疗服务的患者护理报告（PCR）联系起来，(3)对患者进行定性探索，相对，和护理提供者对脓毒症护理的看法。在（1）中，我们分析住院和门诊医疗服务的利用情况，直到败血症前30天；临床败血症护理，包括医院内和医院间转移；和康复，败血症幸存者的住院和门诊护理以及败血症后24个月前的医疗保健利用费用。我们试图通过潜在类别分析来确定具有相似医疗保健利用率的幸存者类别。在（2）中，PCR与健康声明数据相关联，以建立一个全面的数据库，概述从院前到随访的败血症患者的护理途径。我们调查例如，正确的初始评估是否与急性(例如，当日杀伤力)和长期(例如，新的护理需求，长期死亡率)患者的结局。我们比较了脓毒症特异性筛查工具的性能，如qSOFA，NEWS-2或PRESEP在临床前设置。在（3）中，半结构化访谈以及同步和异步在线焦点小组使用定性内容分析技术进行和分析。
结论：AVENIR研究的结果将有助于更深入地了解德国的脓毒症治疗途径。它们可以作为脓毒症护理改进和创新的基础，从长远来看可以有助于减少个人，medical,脓毒症及其后遗症的社会负担。
背景：在德国临床试验注册中心注册（ID：DRKS00031302，注册日期：2023年5月5日）。
方法：混合方法研究，包括（1）分析来自德国的匿名全国健康索赔数据，（2）将健康声明数据与来自德国两个联邦州研究地区的紧急医疗服务的患者护理报告（PCR）联系起来，(3)对患者进行定性探索，相对，和护理提供者对脓毒症护理的看法。在（1）中，我们分析住院和门诊医疗服务的利用情况，直到败血症前30天；临床败血症护理，包括医院内和医院间转移；和康复，败血症幸存者的住院和门诊护理以及败血症后24个月前的医疗保健利用费用。我们试图通过潜在类别分析来确定具有相似医疗保健利用率的幸存者类别。在（2）中，PCR与健康声明数据相关联，以建立一个全面的数据库，概述从院前到随访的败血症患者的护理途径。我们调查例如，正确的初始评估是否与急性(例如，当日杀伤力)和长期(例如，新的护理需求，长期死亡率)患者的结局。我们比较了脓毒症特异性筛查工具的性能，如qSOFA，NEWS-2或PRESEP在临床前设置。在（3）中，半结构化访谈以及同步和异步在线焦点小组使用定性内容分析技术进行和分析。
结论：AVENIR研究的结果将有助于更深入地了解德国的脓毒症治疗途径。它们可以作为脓毒症护理改进和创新的基础，从长远来看可以有助于减少个人，medical,脓毒症及其后遗症的社会负担。
背景：在德国临床试验注册中心注册（ID：DRKS00031302，注册日期：2023年5月5日）。
