Sepsis mortality and ICU length of stay after the implementation of an intensive care team in the emergency department
© 2023. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI)..
Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. Preintervention and postintervention phases included 4 and 15 months, respectively. Sepsis time zero, SEP-1 compliance, and lag time from time zero to antibiotic administration were compared. Outcomes of interest were mortality and ICU LOS. 1021 septic patients were included. Sixty-six percent fulfilled compliance with 3 h SEP-1 bundle. Lag time from time zero to antibiotic administration was 75 min. Multivariate analysis showed no association between ICU team in the ED and hospital mortality (Log OR 0.94, CI 0.67-1.34; p = 0.73). The ICU team in the ED was associated with prolonged ICU LOS (Log OR 1.21, CI 1.13-1.30; p < 0.01). Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
Internal and emergency medicine - 18(2023), 6 vom: 19. Sept., Seite 1789-1796 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Tuttle, Erin [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-Bacterial Agents |
|---|
| Anmerkungen: |
Date Completed 18.09.2023 Date Revised 28.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s11739-023-03265-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM355783436 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM355783436 | ||
| 003 | DE-627 | ||
| 005 | 20231226065055.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11739-023-03265-0 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1185.xml |
| 035 | |a (DE-627)NLM355783436 | ||
| 035 | |a (NLM)37074499 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Tuttle, Erin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Sepsis mortality and ICU length of stay after the implementation of an intensive care team in the emergency department |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.09.2023 | ||
| 500 | |a Date Revised 28.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI). | ||
| 520 | |a Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. Preintervention and postintervention phases included 4 and 15 months, respectively. Sepsis time zero, SEP-1 compliance, and lag time from time zero to antibiotic administration were compared. Outcomes of interest were mortality and ICU LOS. 1021 septic patients were included. Sixty-six percent fulfilled compliance with 3 h SEP-1 bundle. Lag time from time zero to antibiotic administration was 75 min. Multivariate analysis showed no association between ICU team in the ED and hospital mortality (Log OR 0.94, CI 0.67-1.34; p = 0.73). The ICU team in the ED was associated with prolonged ICU LOS (Log OR 1.21, CI 1.13-1.30; p < 0.01). Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Emergency department | |
| 650 | 4 | |a Intensive care unit | |
| 650 | 4 | |a Length of stay | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Outcomes | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Wang, Xuan |e verfasserin |4 aut | |
| 700 | 1 | |a Modrykamien, Ariel |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Internal and emergency medicine |d 2006 |g 18(2023), 6 vom: 19. Sept., Seite 1789-1796 |w (DE-627)NLM165086432 |x 1828-0447 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:2023 |g number:6 |g day:19 |g month:09 |g pages:1789-1796 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s11739-023-03265-0 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 2023 |e 6 |b 19 |c 09 |h 1789-1796 | ||