A Multicenter Survey of House Staff Knowledge About Sepsis and the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock”

Watkins, Richard R.; Haller, Nairmeen; Wayde, Melinda; Armitage, Keith B.

doi:10.1177/0885066617737304

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…1,13,14 Watkins et al further demonstrated that improvement in outcomes through early norepinephrine intervention in triage time or qualification of early goal-oriented therapy was appropriate within the first three hours resulting in high rates of survival and reduced rates of mortality. 5 Other studies have also identified deterioration in patients' outcomes and increased mortality for the length of stay, lung injury, kidney failure, and organ failure due to delay in initiation of the norepinephrine intervention. 11,13,14 In a larger multicenter study, hourly delay in the initiation of the norepinephrine intervention was linked to increasing in-facility mortality from the enrollment of the population based on a random sample that used disease code.…”

Section: Discussionmentioning

confidence: 99%

“…8,14,15 To ascertain the effectiveness of norepinephrine timing in the treatment of sepsis and septic shock is important based on quantitative determination of whether or not early norepinephrine administration could improve the outcomes for septic shock patients. 2,5 The purpose of this study is evaluating whether the time to norepinephrine administration is linked to hospital mortality for a patient with sepsis and septic shock in the emergency department using univariate regression analysis to ascertain the effect of survival rate among selected clinical parameters.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Early Administration of Norepinephrine in Septic Shock and Survival

Alshahrani¹

2021

OAEM

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Introduction: Septic shock still carries a high mortality rate despite all advances in emergency and critical care practices. Early interventions have been proven in many aspects to improve outcome. However, early administration of vasopressors namely norepinephrine in septic shock is still controversial. Objective: To identify the association between early norepinephrine administration and mortality in septic shock patients. Methods: A retrospective review of a prospectively collected ICU data for septic shock patients in medical and surgical intensive care units for one year period was carried out. Case definition was based on sepsis 3 definitions. Data included patients' characteristics of demographics, admission diagnosis, APACHE II score, physiological data (including vital signs and laboratory values). The primary outcome was 28 days of mortality. Results: A total of 243 patients identified during the study period, 132 (54.3%) were male. The mean age was found to be 58.9 ± 20.3. The overall rate of 28 days mortality was 87 (47.5%). Norepinephrine was started for 68.9% of the patients in ICU, the rest were started in the emergency department. The highest survival rates were among patients who received norepinephrine within first hour (58.1%) and second (51.5%). A binary logistic regression analysis has been performed to adjust for possible confounders. It was revealed that being intubated and mechanically ventilated or having higher APACHE II score were strongly associated with non-survival rates (OR=7.049, p-0.002), (OR=1.124, p-<0.001) respectively. Conclusion: Our results showed that septic shock patients who had early administration of norepinephrine had a higher survival rate. Intubation and invasive ventilation and higher APACHE II score associated with higher none survival rate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Early Administration of Norepinephrine in Septic Shock and Survival

Alshahrani¹

2021

OAEM

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“…In addition, hospital factors such as reduced staff numbers out-of-hours may result in reduced use of post-operative ward-based protocols such as early patient ambulation, which have been shown to decrease post-operative pneumonia risk 33 . Similarly, reduced ward staff numbers out-of-hours could also contribute to the higher rates of sepsis among patients undergoing out-of-hours cholecystectomy, because of delays in diagnosis 34 . The impact of these systemic factors requires further investigation in the context of out-of-hours cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, reduced ward staff numbers out-of-hours could also contribute to the higher rates of sepsis among patients undergoing out-of-hours cholecystectomy, because of delays in diagnosis 34 . The impact of these systemic factors requires further investigation in the context of out-of-hours cholecystectomy.…”

Section: Publication Biasmentioning

confidence: 99%

Outcomes following out-of-hours cholecystectomy: A systematic review and meta-analysis

Bhat

Varghese

et al. 2021

Preprint

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Background: Cholecystectomy is one of the most commonly performed abdominal operations. Demands on acute operating theatre availability have led to out-of-hours (evenings, nights, or weekend) cholecystectomy being performed, although it is not known whether outcomes differ between out-of-hours and in-hours (daytime on weekdays) cholecystectomy. Objective: This systematic review and meta-analysis aimed to compare outcomes following out-of-hours versus in-hours urgent cholecystectomy. Methods: MEDLINE, EMBASE and Scopus databases were systematically searched from inception to December 2020 for studies comparing outcomes from out-of-hours and in-hours urgent cholecystectomy in adults. The outcomes of interest were rates of bile leakage, bile duct injury (BDI), overall post-operative complications, conversion to open cholecystectomy, specific intra- and post-operative complications, length of stay (LOS), readmission and mortality. Sensitivity analysis of adjusted multivariate results was also performed. Results: In total, 194,135 urgent cholecystectomies (30,001 out-of-hours; 164,134 in-hours) from 11 studies were included. Most studies were of high (64%) or medium (18%) quality. There were no differences between out-of-hours and in-hours cholecystectomy for rates of bile leakage, BDI, overall post-operative complications, conversion to open cholecystectomy, operative duration, readmission, mortality, and post-operative LOS. Higher rates of post-operative sepsis (odds ratio (OR) 1.58, 95% CI: 1.04-2.41; p=0.03) and pneumonia (OR 1.55, 95% CI: 1.06-2.26; p=0.02) were observed following out-of-hours cholecystectomy on univariate meta-analysis but not on adjusted multivariate meta-analysis. Conclusions: There was no increased risk or difference in specific complications associated with out-of-hours compared with in-hours urgent cholecystectomy.

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“…Jednocześnie ponad 84% było przekonanych o swojej usystematyzowanej wiedzy. Dane te powinny być motywacją do skoncentrowania się również na edukacji osób, które pośrednio biorą udział w opiece nad pacjentem, gdyż każda osoba zaangażowana we wczesne identyfikowanie objawów może przyczynić się do zmniejszonej liczby wystąpień sepsy [22]. Jednocześnie dobrze wykwalifikowany personel medyczny ma możliwość w rzetelny sposób przekazywać informacje społeczeństwu i realizować funkcję profilaktyczną.…”

Section: Rola Pielęgniarek/pielęgniarzy W Zapobieganiu I Leczeniu Sepsyunclassified

The role of nursing stuff in the early identification, prophylaxis and treatment of sepsis in the light of the new definition of sepsis

Mazur¹,

Czarkowska–Pączek²

2018

Pielegniarstwo XXI Wieku / Nursing in the 21st Century

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Introduction. It is estimated that every year 31 million people suffer from sepsis and even 6 million cases of illness end up in the patient’s death. In 2016 the current definition of sepsis was established as a life-threatening multiorgan failure resulting from an abnormal immune response caused by patient infection. The pathobiological approach rejects the current method of diagnosing sepsis based on the occurrence of SIRS, because many other non-infectious diseases may also cause its occurrence. There was proposed a scale of progressive organ failure called SOFA and qSOFA. In May 2017, WHO released a resolution that obliges European Union countries to raise awareness about sepsis prevention, diagnosis, treatment and management.Results. A nurse is the person who spends the most time with a patient, thus becoming the best observer of changes in his/her vital functions and well-being. Nurses working in basic health care, hospital emergency ward and all departments not involved in intensive medical care, have an important role in prevention of infections, as over 70% of sepsis cases begins in a non-hospital environment, and the current level of public knowledge reaches only 14%.

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A Multicenter Survey of House Staff Knowledge About Sepsis and the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock”

Abstract: Additional education of IM and EM house staff on the Surviving Sepsis Campaign Guidelines is warranted, along with more consistent feedback regarding their diagnosis and management of sepsis.

Cited by 14 publications

References 17 publications

Association Between Early Administration of Norepinephrine in Septic Shock and Survival

Association Between Early Administration of Norepinephrine in Septic Shock and Survival

Outcomes following out-of-hours cholecystectomy: A systematic review and meta-analysis

The role of nursing stuff in the early identification, prophylaxis and treatment of sepsis in the light of the new definition of sepsis

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