ICU Admission Source as a Predictor of Mortality for Patients With Sepsis
Authors
Motzkus, Christine A.Chrysanthopoulou, Stavroula A.
Luckmann, Roger
Rincon, Teresa A.
Lapane, Kate L.
Lilly, Craig M.
UMass Chan Affiliations
Department of MedicineDepartment 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 ArticlePublication Date
2017-04-07Keywords
emergency departmentintensive care unit
sepsis
Bacterial Infections and Mycoses
Critical Care
Emergency Medicine
Pathological Conditions, Signs and Symptoms
Metadata
Show full item recordAbstract
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 siteDOI
10.1177/0885066617701904Permanent Link to this Item
http://hdl.handle.net/20.500.14038/29189PubMed ID
28385105Notes
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