Epidemiology of Emergency Department Sepsis: A National Cohort Study Between 2001 and 2012

Yu, Chin Wei; Chang, Shy Shin; Lai, Chih Cheng; Wu, Jiunn Yih; Yen, Debra W.; Lee, Meng Tse Gabriel; Yeh, Chien Chun; Chung, Jui-Yuan; Lin, Yu; Lee, Chien‐Chang

doi:10.1097/shk.0000000000001219

Cited by 16 publications

(19 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the United States, there were over 750,000 cases in 1995, 61% of whom were admitted through the emergency department (ED) [1,2]. In China, the number of sepsis patients was even greater at 1,256,684 between 2001 and 2012, 29.3% of whom were admitted via the ED [3]. With so many sepsis patients presenting at the ED, prompt and appropriate management in this department is crucial.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department

et al. 2019

View full text Add to dashboard Cite

Sepsis is a condition that requires appropriate antibiotic treatment at the emergency department (ED). Most previous studies conducted on inappropriate antibiotic use at the ED were conducted in developed countries with a low percentage of sepsis. This study aimed to find additional clinical predictors for appropriate antibiotic use in bacteremia patients presenting at the ED from a developing country, in which there is a higher proportion of patients with sepsis. We included adult patients who presented at the ED with clinical suspicion of infection and bacteremia. Patients allocated to the appropriate antibiotic group were those in whom the prescribed antibiotic was sensitive to the pathogen. Predictors and outcomes of appropriate antibiotic use were analyzed. A total of 3133 patients who met the study criteria presented at the ED during the study period. Of those, 271 patients were diagnosed with bacteremia, 48 of whom (17.71%) received inappropriate antibiotic prescriptions. Only pulse rate was an independent factor for appropriate antibiotic treatment, with an adjusted odds ratio of 1.019 (95% CI of 1.001, 1.036). In terms of clinical outcomes, the inappropriate antibiotic group had higher proportions of 28-day mortality (29.17% vs. 25.25%; p-value = 0.022) and longer hospitalization (14 vs. 9 days; p-value = 0.003). This study found that inappropriate antibiotics were prescribed in 17% of bacteremia patients presenting at the ED and that high pulse rate was an indicator for appropriate antibiotic prescription. Patients with inappropriate antibiotic administration had longer hospitalization and higher 28-day mortality than those who received appropriate antibiotic treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department

et al. 2019

View full text Add to dashboard Cite

show abstract

“…1,2,5 Among the infections, those of the urinary tract and pneumonia stand out, with the latter increasing the mortality risk; a high number of patients with urinary infection reported negative cultures. 8,9,19 Severity assessment scales (APACHE II, SAPS II, SOFA, qSOFA and MPM0-II) mean scores were significantly higher in patients who died. 2 We observed that lactate was significantly higher in non-survivors.…”

Section: Discussionmentioning

confidence: 95%

“…5 Infections are one of the main causes of attention at emergency departments (EDs), and on numerous occasions they trigger sepsis and septic shock. Paradoxically, most studies focus on the management of patients with sepsis in intensive care units (ICUs), 6,7 even though initial management at EDs is key [6][7][8] and numerous patients with septic shock will not be admitted to ICUs. 1 Understanding the relevance of EDs is vital for directing resources and implementing quality improvement measures.…”

Section: Introductionmentioning

confidence: 99%

Sepsis and septic shock in emergency departments of Mexico: a multicenter point prevalence study

Gorordo-Delsol¹,

Merinos-Sánchez²,

Estrada-Escobar³

et al. 2023

GMM

View full text Add to dashboard Cite

Introduction: Sepsis is one of the main reasons for consultation at emergency departments. Objective: To identify the prevalence of sepsis in emergency departments of Mexico. Method: Cross-sectional study with a 30-day follow-up of patients diagnosed with sepsis or septic shock; demographic variables, management and outcomes were analyzed. Results: In 68 emergency departments analyzed, 2379 patients were attended to, out of whom 307 had sepsis. The prevalence of sepsis was 12.9 %, and overall mortality was 16.93 %, which in the cases of sepsis was 9.39 %, and in those of septic shock, 65.85 %; no significant differences were identified in demographic variables or type of hospital. A significantly higher fluid balance was observed within the first three hours in those patients who died, as well as a lack of adherence to international resuscitation recommendations. Conclusions: A high prevalence of sepsis was found in Mexican emergency departments. Mortality of patients with septic shock was similar and even higher than that internationally reported.

show abstract

“…Globally, it is estimated that between 20-30 million people develop sepsis annually and that eight million will die each year. 1 Prompt treatment and identification of the infectious etiology is key in preventing end-organ damage and or death. In rare instances, patients can develop complications from sepsis; one such complication is autoimmune hemolytic anemia.…”

Section: Introductionmentioning

confidence: 99%

Sepsis-induced Autoimmune Hemolytic Anemia: A Case Report

Edwards

DeMeo

2020

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

Introduction: Sepsis commonly brings patients to the emergency department (ED). Patient outcomes can vary widely. In some cases, rare complications of sepsis such as autoimmune hemolytic anemia can occur. Case Report: A 68-year-old female presented with sepsis secondary to infected nephrolithiasis. The patient had signs and symptoms consistent with hemolysis upon arrival to the ED. Her hemolysis progressively worsened over a two-day period leading to a diagnosis of warm autoimmune hemolytic anemia. She responded well to treatment; however, her condition began to worsen due to a new infection caused by perforated colonic diverticula. The patient ultimately expired from complications of her perforated colonic diverticula. Conclusion: It is crucial that emergency physicians understand the risk factors, symptoms, pathophysiology, and treatment of this rare complication of sepsis so that favorable patient outcomes can be achieved.

show abstract

Epidemiology of Emergency Department Sepsis: A National Cohort Study Between 2001 and 2012

Cited by 16 publications

References 33 publications

Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department

Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department

Sepsis and septic shock in emergency departments of Mexico: a multicenter point prevalence study

Sepsis-induced Autoimmune Hemolytic Anemia: A Case Report

Contact Info

Product

Resources

About