Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards.
Citation: Journal of Critical Care. 30(1):78-84, 2015 Feb.PMID: 25128441Institution: MedStar Washington Hospital CenterDepartment: Emergency MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | Observational Study | Research Support, N.I.H., ExtramuralSubject headings: *Hospital Mortality | *Hospitalization | *Sepsis/mo [Mortality] | Aged | APACHE | Emergency Service, Hospital | Female | Humans | Intensive Care Units | Male | Middle Aged | Patient Transfer/sn [Statistics & Numerical Data] | Retrospective Studies | Risk Factors | Sepsis/ep [Epidemiology] | United StatesLocal holdings: Available online through MWHC library: 2012 - presentISSN:- 0883-9441
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | Available | 25128441 |
Available online through MWHC library: 2012 - present
CONCLUSIONS: Patients presenting to the emergency department with severe sepsis were frequently admitted to a non-ICU setting, and the rate increased over time. Of 8 patients admitted to the hospital ward, one was transferred to the ICU within 48 hours and/or died within 28 days of admission. Factors present at admission were identified that were associated with adverse outcomes.Copyright � 2014 Elsevier Inc. All rights reserved.
MATERIAL AND METHODS: This was a single-center retrospective cohort study conducted at a tertiary, academic hospital in the United States between 2005 and 2009. The primary outcome was a composite outcome of ICU transfer within 48 hours of admission and/or 28-day mortality.
PURPOSE: The purpose of this study was to detail the trajectory and outcomes of patients with severe sepsis admitted from the emergency department to a non-intensive care unit (ICU) setting and identify risk factors associated with adverse outcomes.
RESULTS: Of 1853 patients admitted with severe sepsis, 841 (45%) were admitted to a non-ICU setting, the rate increased over time (P < .001), and 12.5% of these patients were transferred to the ICU within 48 hours and/or died within 28 days. In multivariable models, age (P < .001), an oncology diagnosis (P < .001), and illness severity as measured by Acute Physiologic and Chronic Health Evaluation II (P = .04) and high (>4 mmol/L) initial serum lactate levels (P = .005) were associated with the primary outcome.
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