The Study of Laboratory Testing for Sepsis Diagnosis Model at Chomthong Hospital, Chiang Mai Province

Abstract

Purposes: To development and rigorously evaluate a rational laboratory test model for the diagnosis of sepsis at Chomthong Hospital, Chiang Mai Province.

Study design: Exploratory Research and Development.

Materials and Methods: An exploratory research and development design was employed, utilizing retrospective data from medical records of 896 inpatients aged 18 years and older diagnosed with sepsis between October 1, 2023, and September 30, 2024, selected through purposive sampling. Statistical analysis comprised the Chi-square test with a significance threshold set at .005. Clinical sensitivity and specificity were evaluated in accordance with the qSOFA, SOFA, and SEPSIS-3 guidelines. Multivariate associations were further examined using advanced statistical modeling, with findings reported as odds ratios and 95% confidence intervals.

Main findings: The results indicated that abnormal laboratory findings were observed in 62.07% of the sepsis group and 67.16% of the septic shock group. No significant association was observed between the frequency of laboratory testing and abnormal findings (Sepsis: r = -0.25, p = 0.43; Septic shock: r = -0.06, p = 0.86). Univariate analysis identified eleven biomarkers significantly associated with septic shock (p < .05), with sensitivities ranging from 0.53 to 0.65 and specificities from 0.52 to 0.67. Multivariate analysis demonstrated that albumin, BUN, lactate, platelet count, and creatinine were strong predictors for differentiating sepsis from septic shock (AUC ≈ 0.86, accuracy = 0.82). Implementation of the Rational Laboratory Use (RLU) approach is projected to reduce annual laboratory costs by 12.26%.

Conclusion and recommendations: It is recommended that the RLU model be integrated into clinical laboratories across hospitals of all sizes to enhance the appropriateness, efficiency, and cost-effectiveness of laboratory testing.