How clinical parameters predict length of hospital stay for sepsis patients at RSUD Kanjuruhan Kepanjen Hospital (2016-2018)
In the busy emergency department of RSUD Kanjuruhan Kepanjen between 2016-2018, doctors and nurses battled an invisible enemy: sepsis. This deadly condition, an uncontrolled body response to infection, claimed the lives of up to one-third of those affected, with mortality rates in Africa reaching 47% 2 . Each hour of delay in treatment can significantly increase patient mortality risk 7 .
In this race against time, healthcare professionals are armed with data and numbers. Two sets of simple yet powerful information—vital signs and complete blood count laboratory parameters—become their guides. This article explores how these datasets, collected from medical records of sepsis patients at RSUD Kanjuruhan Kepanjen, not only help save lives but also predict a crucial outcome: patient length of hospital stay.
Sepsis isn't just a common infection. It's a cytokine storm in the body, where the immune system that should fight infection instead turns to attack the body's own organs and tissues. This causes organ damage, circulatory failure, and can ultimately be fatal if not treated quickly and appropriately 1 3 .
Fever or very low body temperature (hypothermia)
Racing heart (pulse rate > 90 beats per minute)
Rapid breathing (respiratory rate > 20 times per minute)
Low blood pressure
Altered mental status (confusion, lethargy, especially in children) 1
In diagnosing and monitoring sepsis, clinicians rely on two main allies: vital sign measurements at the patient's bedside and laboratory parameter analysis from blood samples.
Vital signs are the first line in the sepsis narrative. They provide a direct, real-time picture of how the patient's body is responding to infection stress.
In clinical practice, vital signs are often compiled into an early warning score. A recent prospective study found that the Modified Early Warning Score (MEWS)—which combines assessment of blood pressure, pulse, respiratory rate, temperature, and mental status—showed good performance in identifying sepsis patients and even predicting mortality in the ICU 2 .
An innovative study using machine learning on data from 2,630 patients found that the simple combination of pulse rate (HR) and temperature (Temp) alone could predict sepsis onset up to 6 hours in advance with very promising accuracy 7 .
If vital signs are the alarm, then blood laboratory tests are the investigators who enter the scene to gather evidence.
Tests like creatinine (kidney function) and bilirubin (liver function) help assess the extent of organ dysfunction 2 .
Imagine a study designed to map the journey of sepsis patients. The goal is to see whether data collected in the first hours—vital signs and laboratory results—can predict not only life or death, but also how long they need to stay in the hospital.
The study involved adult patients hospitalized with sepsis diagnosis at RSUD Kanjuruhan Kepanjen between 2016 and 2018.
In the first hours after admission, the following data were carefully recorded: vital signs and blood samples for laboratory analysis.
Vital sign data were used to calculate composite scores like MEWS or NEWS (National Early Warning Score) 2 3 .
The main variable measured was Length of Hospital Stay—from admission date to discharge date.
Statistical analysis of this data would likely reveal important patterns. The following tables present hypothetical findings from such a study, based on current scientific evidence.
| Parameter at Admission | Average Length of Stay | Description |
|---|---|---|
| Lactate < 2 mmol/L | 7 days | Good organ perfusion, faster recovery |
| Lactate > 4 mmol/L | 18 days | Septic shock, requires intensive resuscitation and organ support |
| Normal Platelets | 9 days | No significant coagulation disorders |
| Thrombocytopenia | 15 days | Indicates organ dysfunction and disease severity |
| MEWS < 5 | 8 days | Relatively stable clinical status |
| MEWS ≥ 5 | 14 days | Worsening clinical condition, requires closer monitoring |
In sepsis research and daily management, these tools and reagents are among the most important:
Automatically counts white blood cells, red blood cells, and platelets from complete blood samples 8 .
Measures lactate levels, blood pH, oxygen, and electrolytes quickly .
Special media for growing microorganisms from patient blood - the "gold standard" for identifying sepsis-causing pathogens 1 .
Research linking vital signs, laboratory parameters, and length of stay of sepsis patients at RSUD Kanjuruhan Kepanjen is not just an academic exercise. It is an effort to leverage existing data to build a better future of care. By understanding these patterns, hospitals can:
Ultimately, every number on the vital signs chart and every result from the laboratory machine tells a story. By reading these stories carefully, doctors and nurses at RSUD Kanjuruhan Kepanjen, and everywhere else, not only save lives but also ensure each patient's journey to recovery is as efficient and humane as possible.