.jpg "KETAKI KARPE, BS, MS, RPh photo")
KETAKI KARPE, BS, MS, RPh
SENIOR MEDICAL ADVISOR
RadiometerAmerica, a Danaher Corporation
Brea, California
Disclosure information not submitted.
Susanne Nickelsen, MD
Senior Director – Clinical & Medical Affairs
Radiometer Medical ApS, United States
Disclosure information not submitted.
Jonathan Lilley, n/a
Healthcare Associate
Boston Strategic Partners, Inc., United States
Disclosure information not submitted.
Halit Yapici, MD MBA MPH
Engagement Manager
Boston Strategic Partners, Inc., United States
Disclosure information not submitted.
Title: A Retrospective Analysis to Assess BMP Testing in ICU Patients Diagnosed with Sepsis
Introduction: Sepsis and its complications are common causes of morbidity/mortality, and often lead to intensive care unit (ICU) admissions as well as disturbances in fluid and electrolyte balance. Early goal-directed therapy has shown clinical benefits in patients with sepsis. Electrolyte deficiencies (e.g., hypocalcemia) are associated with an increased risk of adverse events and should be corrected. Basic metabolic panel (BMP or CHEM8) can be utilized to identify imbalances of eight distinct parameters, which are markers for various processes, including nerve and muscle function, acid-base balance, and excretion of metabolic by-products. This study investigates the frequency of BMP testing in patients admitted to the ICU with sepsis in the US and highlights the gaps in testing practices.
Methods: Electronic Health Records from the Cerner Real-World Data (01/2018-03/2021) were analyzed to describe trends in laboratory testing in patients diagnosed with sepsis/bacteremia (based on ICD-10-CM codes) in the ICU. The counts of distinct encounters and the total number of laboratory tests ordered were evaluated for the following parameters: calcium, sodium, chloride, potassium, glucose, carbon dioxide, creatinine, and blood urea nitrogen in whole blood, serum or plasma. The proportion of encounters where each BMP parameter was ordered, and the number of each test ordered per encounter were calculated.
Results: The analysis included 75,970 distinct encounters with a sepsis diagnosis in the ICU from 103 institutions. Tests for ≥1 of the BMP parameters were ordered in 74.1% of encounters, while none of the BMP parameters were tested in 25.9%. The most ordered tests were glucose (73.6% of encounters) and sodium (73.0%), followed by chloride (72.9%), potassium (72.7%), creatinine (72.4%), and calcium (71.9%). Among patients tested, creatinine and calcium were found to be tested ~16 times per encounter.
Conclusions: A lack of laboratory testing was observed in a large ICU patient population diagnosed with sepsis. BMP parameters were not ordered in over 25% of patient encounters. BMP parameters (e.g., calcium) can provide insights for optimal management of sepsis and support life-saving clinical decisions. Studies are needed to evaluate the impact of BMP testing on the clinical outcomes in ICU patients with sepsis.