Sepsis-Associated Encephalopathy (SAE) as an Early Predictor of Mortality: Using Neurological Status (GCS or Delirium Scores) upon ED Admission to Predict Long-Term Outcomes in Septic Patients.
Year: 2026
Type: article
Abstract: Background: Sepsis-Associated Encephalopathy (SAE) is a dangerous and multifactorial complication of sepsis, causing diffuse dysfunction of the brain, and is a common presentation in the Emergency Department (ED). Sepsis-associated encephalopathy (SAE) presents a spectrum from mild cognitive deficits to deep coma. However, the lack of specific biomarkers and the confounding effects of sedation make SAE a challenging diagnosis of exclusion. It requires the systematic elimination of alternative etiologies for altered mentation in the febrile, critically ill patient. Objective: To evaluate the efficacy of neurological assessment tools and biochemical markers at ED admission as early predictors of Sepsis-Associated Encephalopathy and long-term patient outcomes. Methodology: A comprehensive analysis of studies showing the GCS scores and Delirium screening in ED during admission for early identification of SEA and determination of 28-day mortality and long-term cognitive outcomes based on data from published literature. Result: The analysis of literature reveals that SEA affects 53% to 70% of patients. A GCS score of ≤14 on average during admission carries a 49.3% mortality rate, while GCS scores between 3–8 increases the risk to 63%. Delirium increases mortality by 4.3-fold, showing a 15.8% mortality after 28 days and long-term cognitive decline. Conclusion: Early identification of Sepsis-Associated Encephalopathy clinically calculating the GCS scores and delirium screening on arrival in the ED is essential and beneficial as these assessments serve as powerful independent and non-invasive predictors of 28-day mortality and long-term cognitive impairment, enabling clinicians to implement critical neuroprotective strategies and improve prognostic chances immediately upon admission.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7214813441