TY  - BOOK
AU  - Goyal, Munish
TI  - Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards
SN  - 0883-9441
KW  - *Hospital Mortality
KW  - *Hospitalization
KW  - *Sepsis/mo [Mortality]
KW  - Aged
KW  - APACHE
KW  - Emergency Service, Hospital
KW  - Female
KW  - Humans
KW  - Intensive Care Units
KW  - Male
KW  - Middle Aged
KW  - Patient Transfer/sn [Statistics & Numerical Data]
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Sepsis/ep [Epidemiology]
KW  - United States
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Journal Article
KW  - Observational Study
KW  - Research Support, N.I.H., Extramural
N1  - Available online through MWHC library: 2012 - present
N2  - 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
UR  - http://dx.doi.org/10.1016/j.jcrc.2014.07.012
ER  -