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Epidemiology of severe sepsis in the emergency department and difficulties in the initial assistance.

Rezende E, Silva JM, Isola AM, Campos EV, Amendola CP, Almeida SL - Clinics (Sao Paulo) (2008)

Bottom Line: The median hospital length of stay was 10 (4.7-17) days, and the hospital mortality rate was 64%.Only 31% of the patients were diagnosed by the emergency department team as septic.Training improved diagnosis and decreased the time delay for septic patients in arriving at the ICU.

View Article: PubMed Central - PubMed

Affiliation: Hospital do Servidor Publico Estadual, Serviço de Terapia Intensiva, São Paulo, SP, Brazil.

ABSTRACT

Background: The aim of this study was to determine the occurrence rate, demographics, clinical characteristics, and outcomes of patients with severe sepsis admitted to the emergency department.

Methods: A prospective study evaluating all patients admitted to the emergency department unit in a public hospital of tertiary complexity in a six-month period was conducted. During this period, the emergency team was trained to diagnose sepsis. Patients who met the diagnostic criteria for severe sepsis were followed until their discharge from the hospital.

Results: A total of 5,332 patients were admitted to the emergency department, and 342 met the criteria for severe sepsis/septic shock. The median (interquartile range) age of patients was 74 (65-84) years, and 52.1% were male. The median APACHE II and SOFA scores at diagnosis were 19 (15-25) and 5 (3-7), respectively. The median number of dysfunctional organ systems per patient was 2 (1-3). The median hospital length of stay was 10 (4.7-17) days, and the hospital mortality rate was 64%. Only 31% of the patients were diagnosed by the emergency department team as septic. About 33.5% of the 342 severe sepsis patients admitted to the emergency department were referred to an ICU, with a median time delay of 24 (12-48) hours. Training improved diagnosis and decreased the time delay for septic patients in arriving at the ICU.

Conclusions: The occurrence rate of severe sepsis in the emergency department was 6.4%, and the rate of sepsis diagnosed by the emergency department team as well as the number of patients transferred to the ICU was very low. Educational campaigns are important to improve diagnosis and, hence, treatment of severe sepsis.

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Related in: MedlinePlus

Severe sepsis occurrence in patients admitted to the ED during the period of the study. Columns indicate the percentage of all patients
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getmorefigures.php?uid=PMC2664120&req=5

f1-cln63_4p0457: Severe sepsis occurrence in patients admitted to the ED during the period of the study. Columns indicate the percentage of all patients

Mentions: During the study period, 5332 patients were admitted to the ED and 369 (6.9%) of them fulfilled the criteria for severe sepsis, but of those, only 342 (6.4%) patients met inclusion criteria and 27 (0.5%) patients were excluded because they presented with serious underlying diseases. The occurrence rate of severe sepsis in the ED during the study is presented in Figure 1.


Epidemiology of severe sepsis in the emergency department and difficulties in the initial assistance.

Rezende E, Silva JM, Isola AM, Campos EV, Amendola CP, Almeida SL - Clinics (Sao Paulo) (2008)

Severe sepsis occurrence in patients admitted to the ED during the period of the study. Columns indicate the percentage of all patients
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664120&req=5

f1-cln63_4p0457: Severe sepsis occurrence in patients admitted to the ED during the period of the study. Columns indicate the percentage of all patients
Mentions: During the study period, 5332 patients were admitted to the ED and 369 (6.9%) of them fulfilled the criteria for severe sepsis, but of those, only 342 (6.4%) patients met inclusion criteria and 27 (0.5%) patients were excluded because they presented with serious underlying diseases. The occurrence rate of severe sepsis in the ED during the study is presented in Figure 1.

Bottom Line: The median hospital length of stay was 10 (4.7-17) days, and the hospital mortality rate was 64%.Only 31% of the patients were diagnosed by the emergency department team as septic.Training improved diagnosis and decreased the time delay for septic patients in arriving at the ICU.

View Article: PubMed Central - PubMed

Affiliation: Hospital do Servidor Publico Estadual, Serviço de Terapia Intensiva, São Paulo, SP, Brazil.

ABSTRACT

Background: The aim of this study was to determine the occurrence rate, demographics, clinical characteristics, and outcomes of patients with severe sepsis admitted to the emergency department.

Methods: A prospective study evaluating all patients admitted to the emergency department unit in a public hospital of tertiary complexity in a six-month period was conducted. During this period, the emergency team was trained to diagnose sepsis. Patients who met the diagnostic criteria for severe sepsis were followed until their discharge from the hospital.

Results: A total of 5,332 patients were admitted to the emergency department, and 342 met the criteria for severe sepsis/septic shock. The median (interquartile range) age of patients was 74 (65-84) years, and 52.1% were male. The median APACHE II and SOFA scores at diagnosis were 19 (15-25) and 5 (3-7), respectively. The median number of dysfunctional organ systems per patient was 2 (1-3). The median hospital length of stay was 10 (4.7-17) days, and the hospital mortality rate was 64%. Only 31% of the patients were diagnosed by the emergency department team as septic. About 33.5% of the 342 severe sepsis patients admitted to the emergency department were referred to an ICU, with a median time delay of 24 (12-48) hours. Training improved diagnosis and decreased the time delay for septic patients in arriving at the ICU.

Conclusions: The occurrence rate of severe sepsis in the emergency department was 6.4%, and the rate of sepsis diagnosed by the emergency department team as well as the number of patients transferred to the ICU was very low. Educational campaigns are important to improve diagnosis and, hence, treatment of severe sepsis.

Show MeSH
Related in: MedlinePlus