{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:56:49Z","timestamp":1791223009070,"version":"4.1.0"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Sepsis is a life-threatening condition associated with substantial morbidity and mortality worldwide. In Ireland, the majority of sepsis cases are community-acquired; however, patients presenting to emergency departments (EDs) with suspected severe infection remain poorly characterised, particularly those not captured in administrative datasets. This retrospective cross-sectional observational study will be conducted in the ED of Mater Misericordiae University Hospital, Dublin. Adult (non-maternity) ED presentations across eight predefined 24-hour sampling periods will be reviewed. Community-acquired acute infection will be identified through manual review of ED clinical documentation, and possible sepsis will be identified using the ED triage sepsis discriminator supported by clinical documentation. Data collected will include demographic characteristics, referral pathways, clinical presentation, and patient outcomes. Multivariable logistic regression will be used to identify factors associated with adverse outcomes, defined as intensive care unit admission or in-hospital mortality. This study will provide a detailed evaluation of ED presentations with suspected severe infection in Ireland, including patients not captured in existing national datasets. Findings will contribute to improved understanding of early sepsis recognition, referral pathways, and resource planning in emergency care.<\/jats:p>","DOI":"10.1371\/journal.pone.0359954","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:31:33Z","timestamp":1791221493000},"page":"e0359954","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing community-acquired acute infection in an irish emergency department: A retrospective observational study protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1199-6793","authenticated-orcid":true,"given":"Nandakumar","family":"Ravichandran","sequence":"first","affiliation":[{"name":"School of Medicine, University College Dublin","place":["Dublin, Ireland"]},{"name":"Mater Misericordiae University Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0780-8614","authenticated-orcid":true,"given":"Etimbuk","family":"Umana","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin","place":["Dublin, Ireland"]},{"name":"Mater Misericordiae University Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Breslin","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin","place":["Dublin, Ireland"]},{"name":"Mater Misericordiae University Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"Cotter","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin","place":["Dublin, Ireland"]},{"name":"Mater Misericordiae University Hospital","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Cullen","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"8","key":"pone.0359954.ref001","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"18","key":"pone.0359954.ref002","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.3390\/healthcare13182264","article-title":"Clinical Characteristics and Mortality in Community-Acquired Sepsis and Septic Shock Patients in the Intensive Care Unit Setting in Latvia: An Observational Study","volume":"13","author":"L Puceta","year":"2025","journal-title":"Healthcare (Basel)"},{"issue":"5","key":"pone.0359954.ref003","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.CCM.0000260960.94300.DE","article-title":"Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward","volume":"35","author":"A Esteban","year":"2007","journal-title":"Crit Care Med"},{"key":"pone.0359954.ref004","unstructured":"Centres for Disease Control and Prevention. 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Cross-sectional data from a survey of general practices","volume":"22","author":"C Collins","year":"2021","journal-title":"BMC Fam Pract"},{"key":"pone.0359954.ref008","author":"MMU Hospital","year":"2026"},{"issue":"1","key":"pone.0359954.ref009","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12913-023-10509-4","article-title":"Understanding health care pathways of patients with sepsis: protocol of a mixed-methods analysis of health care utilization, experiences, and needs of patients with and after sepsis","volume":"24","author":"C Fleischmann-Struzek","year":"2024","journal-title":"BMC Health Serv Res"},{"issue":"23","key":"pone.0359954.ref010","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1703058","article-title":"Time to Treatment and Mortality during Mandated Emergency Care for Sepsis","volume":"376","author":"CW Seymour","year":"2017","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0359954.ref011","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s12939-017-0703-y","article-title":"Referral patterns, delays, and equity in access to advanced paediatric emergency care in Vietnam","volume":"16","author":"E Treleaven","year":"2017","journal-title":"Int J Equity Health"},{"issue":"1","key":"pone.0359954.ref012","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1186\/s12913-025-13201-x","article-title":"Validating adverse events in administrative healthcare data in ireland: a retrospective chart review study","volume":"25","author":"A Connolly","year":"2025","journal-title":"BMC Health Serv Res"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:31:35Z","timestamp":1791221495000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359954"}},"subtitle":[],"editor":[{"given":"Ramya","family":"Iyadurai","sequence":"first","affiliation":[{"name":"Christian Medical College Vellore","place":["INDIA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0359954","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}