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    ICU Admission Source as a Predictor of Mortality for Patients With Sepsis

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    Authors
    Motzkus, Christine A.
    Chrysanthopoulou, Stavroula A.
    Luckmann, Roger
    Rincon, Teresa A.
    Lapane, Kate L.
    Lilly, Craig M.
    UMass Chan Affiliations
    Department of Medicine
    Department of Family Medicine and Community Health
    Department of Quantitative Health Sciences
    Graduate School of Biomedical Sciences, Clinical and Population Health Research Program
    Document Type
    Journal Article
    Publication Date
    2017-04-07
    Keywords
    emergency department
    intensive care unit
    sepsis
    Bacterial Infections and Mycoses
    Critical Care
    Emergency Medicine
    Pathological Conditions, Signs and Symptoms
    
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    Link to Full Text
    https://doi.org/10.1177/0885066617701904
    Abstract
    PURPOSE: Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR). METHODS: We conducted a retrospective cohort study of 1762 adults with sepsis using ICU record data obtained from a clinical database of an academic medical center. Survival analysis provided crude and adjusted hazard rate ratio (HRR) estimates comparing hospital mortality among patients from hospital wards, EDs, and ORs, adjusted for age, sex, and severity of illness. RESULTS: Mortality of patients with sepsis differed based on the pre-ICU admission site. Compared to patients admitted from an ED, patients admitted from hospital wards had higher mortality (HRR: 1.35; 95% confidence interval [CI]: 1.09-1.68) and those admitted from an OR had lower mortality (HRR: 0.37; 95% CI: 0.23-0.58). CONCLUSION: Patients with sepsis admitted to an ICU from a hospital ward experienced greater mortality than patients with sepsis admitted to an ICU from an ED. These findings indicate that there may be systematic differences in the selection of patient care locations, recognition, and management of patients with sepsis that warrant further investigation.
    Source
    J Intensive Care Med. 2017 Jan 1:885066617701904. doi: 10.1177/0885066617701904. [Epub ahead of print] Link to article on publisher's site
    DOI
    10.1177/0885066617701904
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29189
    PubMed ID
    28385105
    Notes

    First author Christine A. Motzkus is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

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    10.1177/0885066617701904
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