Assessing community-acquired acute infection in an irish emergency department: A retrospective observational study protocol

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.