Journal article
Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards
Journal of critical care, v 30(1)
01 Feb 2015
PMID: 25128441
Featured in Collection : UN Sustainable Development Goals @ Drexel
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. (C) 2014 Elsevier Inc. All rights reserved.
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Details
- Title
- Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards
- Creators
- Stacey-Ann Whittaker - University of PennsylvaniaBarry D. Fuchs - University of PennsylvaniaDavid F. Gaieski - University of PennsylvaniaJason D. Christie - University of PennsylvaniaMunish Goyal - MedStar Georgetown University HospitalNuala J. Meyer - University of PennsylvaniaCraig Kean - University of Pennsylvania Health SystemDylan S. Small - University of PennsylvaniaScarlett L. Bellamy - University of PennsylvaniaMark E. Mikkelsen - University of Pennsylvania
- Publication Details
- Journal of critical care, v 30(1)
- Publisher
- Elsevier
- Number of pages
- 7
- Grant note
- National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Heart, Lung and Blood Institute Loan Repayment Program, Bethesda, MD
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000346238900013
- Scopus ID
- 2-s2.0-84920645167
- Other Identifier
- 991019298663504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine