Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards. 

<br/><br/>Available online through MWHC library: 2012 - present 
<br/><br/> CONCLUSIONS: Patients presenting to the emergency department with severe sepsis were frequently admitted to a non-ICU setting, and the rate increased over time. Of 8 patients admitted to the hospital ward, one was transferred to the ICU within 48 hours and/or died within 28 days of admission. Factors present at admission were identified that were associated with adverse outcomes.Copyright � 2014 Elsevier Inc. All rights reserved.  MATERIAL AND METHODS: This was a single-center retrospective cohort study conducted at a tertiary, academic hospital in the United States between 2005 and 2009. The primary outcome was a composite outcome of ICU transfer within 48 hours of admission and/or 28-day mortality.  PURPOSE: The purpose of this study was to detail the trajectory and outcomes of patients with severe sepsis admitted from the emergency department to a non-intensive care unit (ICU) setting and identify risk factors associated with adverse outcomes.  RESULTS: Of 1853 patients admitted with severe sepsis, 841 (45%) were admitted to a non-ICU setting, the rate increased over time (P < .001), and 12.5% of these patients were transferred to the ICU within 48 hours and/or died within 28 days. In multivariable models, age (P < .001), an oncology diagnosis (P < .001), and illness severity as measured by Acute Physiologic and Chronic Health Evaluation II (P = .04) and high (>4 mmol/L) initial serum lactate levels (P = .005) were associated with the primary outcome. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0883-9441 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Hospital Mortality<br/>*Hospitalization<br/>*Sepsis/mo [Mortality]<br/>Aged<br/>APACHE<br/>Emergency Service, Hospital<br/>Female<br/>Humans<br/>Intensive Care Units<br/>Male<br/>Middle Aged<br/>Patient Transfer/sn [Statistics & Numerical Data]<br/>Retrospective Studies<br/>Risk Factors<br/>Sepsis/ep [Epidemiology]<br/>United States
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Emergency Medicine
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Observational Study<br/>Research Support, N.I.H., Extramural