Details

Autor(en) / Beteiligte

• Whittaker, Stacey-Ann, MD
• Fuchs, Barry D., MD
• Gaieski, David F., MD
• Christie, Jason D., MD, MS
• Goyal, Munish, MD
• Meyer, Nuala J., MD
• Kean, Craig, MS
• Small, Dylan S., PhD
• Bellamy, Scarlett L., ScD
• Mikkelsen, Mark E., MD, MS

Titel

Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards

Ist Teil von

• Journal of critical care, 2015-02, Vol.30 (1), p.78-84

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract 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. 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. 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. 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.