TOPLINE:

A new sepsis prediction score was used in 77% of patients during out-of-hours GP visits in Netherlands, with 85% usage seen in acutely ill patients. GPs found the score convenient, with 93% rating it as easy to use, and it influenced referral decisions in 6% of patients.

METHODOLOGY:

• Researchers conducted a mixed-methods feasibility study at two out-of-hours GP cooperatives in a region in Netherlands and involved 106 GPs and 271 patients (61% aged > 75 years; 42% women) during the 12-week study period.
• The study included a prospective implementation phase and a qualitative investigation, focusing on the feasibility and acceptability of a sepsis prediction score.
• GPs received training on the usage of the new sepsis score and were instructed to use it during home visits, excluding children and terminally ill and deceased patients.
• The sepsis score consisted of six variables, including age, temperature, blood pressure, heart rate, oxygen saturation, and mental status, to predict the risk for sepsis.
• GPs calculated the sepsis score during home visits and completed questionnaires after each visit on its uptake, usability, and influence on referral decisions, with focus groups and interviews with GPs and drivers exploring experiences and perspectives.

TAKEAWAY:

• The sepsis prediction score was used in 77% of all patients and 85% of those who were acutely ill. Among patients for whom the sepsis score was calculated, 18% had a high-risk category score.
• In 6% of patients, the sepsis score influenced the decision to refer patients to the hospital, particularly in high-risk vs intermediate- and low-risk groups (16% vs 7% and 3%).
• Overall, 93% of GPs found the score easy to calculate during home visits, and 10% reported that they based management decisions on it.
• Towards practical usability, a small focus group of GPs and drivers reported that the score's design aligned with the existing practices, making it feasible for routine use without increasing workload. However, concerns were raised for the sensitivity of the score.

IN PRACTICE:

"Our study suggests that a new sepsis prediction score may be acceptable and feasible for use during out-of-hours home visits in primary care, at least under study conditions," the authors wrote. "While the score shows promise in early sepsis recognition, further research is needed to establish its clinical and cost-effectiveness for routine use," they added.

SOURCE:

This study was led by Feike J. Loots, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands. It was published online on November 10, 2025, in the European Journal of General Practice.

LIMITATIONS:

The study's voluntary participation may have introduced selection bias, potentially overestimating the score's uptake and acceptability. The inclusion of nearly all adults during out-of-hours primary care might have reflected general opinions rather than specific utility in scenarios of possible sepsis. The qualitative evaluation was based on a small sample, potentially limiting the findings' depth and representativeness. Data on why GPs refrained from using the score were not collected, and the findings may not be directly applicable to countries with different healthcare systems.

DISCLOSURES:

This research was funded by the Netherlands Organisation for Health Research and Development. One author was supported by the Netherlands Organisation for Health Research and Development ZonMw VENI grant. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.