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Functional outcomes of general medical patients with severe sepsis
BACKGROUND: Severe sepsis is a common cause for admission to the general medical ward. Previous work has demonstrated substantial new long-term disability in patients with severe sepsis, but the short-term functional outcomes of patients admitted to the general medical floor -- where the majority of...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924161/ https://www.ncbi.nlm.nih.gov/pubmed/24330544 http://dx.doi.org/10.1186/1471-2334-13-588 |
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author | Odden, Andrew J Rohde, Jeffrey M Bonham, Catherine Kuhn, Latoya Malani, Preeti N Chen, Lena M Flanders, Scott A Iwashyna, Theodore J |
author_facet | Odden, Andrew J Rohde, Jeffrey M Bonham, Catherine Kuhn, Latoya Malani, Preeti N Chen, Lena M Flanders, Scott A Iwashyna, Theodore J |
author_sort | Odden, Andrew J |
collection | PubMed |
description | BACKGROUND: Severe sepsis is a common cause for admission to the general medical ward. Previous work has demonstrated substantial new long-term disability in patients with severe sepsis, but the short-term functional outcomes of patients admitted to the general medical floor -- where the majority of severe sepsis is treated -- are largely unknown. METHODS: A retrospective cohort study was performed of patients initially admitted to non-ICU medical wards at a tertiary care academic medical center. Severe sepsis was confirmed by three physician reviewers, using the International Consensus Conference definition of sepsis. Baseline functional status, disposition location, and receipt of post-acute skilled care were recorded using a structured abstraction instrument. RESULTS: 3,146 discharges had severe sepsis by coding algorithm; from a random sample of 111 patients, 64 had the diagnosis of severe sepsis confirmed by reviewers. The mean age of the 64 patients was 63.5 years +/- 18.0. Prior to admission, 80% of patients lived at home and 50.8% of patients were functionally independent. Inpatient mortality was 12.5% and 37.5% of patients were discharged to a nursing facility. Of all patients in the cohort, 50.0% were discharged home, and 66.7% of patients who were functionally independent at baseline were discharged to home. CONCLUSIONS: New physical debility is a common feature of severe sepsis in patients initially cared for on the general medical floor. Debility occurs even in those with good baseline physical function. Interventions to improve the poor functional outcomes of this population are urgently needed. |
format | Online Article Text |
id | pubmed-3924161 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-39241612014-02-15 Functional outcomes of general medical patients with severe sepsis Odden, Andrew J Rohde, Jeffrey M Bonham, Catherine Kuhn, Latoya Malani, Preeti N Chen, Lena M Flanders, Scott A Iwashyna, Theodore J BMC Infect Dis Research Article BACKGROUND: Severe sepsis is a common cause for admission to the general medical ward. Previous work has demonstrated substantial new long-term disability in patients with severe sepsis, but the short-term functional outcomes of patients admitted to the general medical floor -- where the majority of severe sepsis is treated -- are largely unknown. METHODS: A retrospective cohort study was performed of patients initially admitted to non-ICU medical wards at a tertiary care academic medical center. Severe sepsis was confirmed by three physician reviewers, using the International Consensus Conference definition of sepsis. Baseline functional status, disposition location, and receipt of post-acute skilled care were recorded using a structured abstraction instrument. RESULTS: 3,146 discharges had severe sepsis by coding algorithm; from a random sample of 111 patients, 64 had the diagnosis of severe sepsis confirmed by reviewers. The mean age of the 64 patients was 63.5 years +/- 18.0. Prior to admission, 80% of patients lived at home and 50.8% of patients were functionally independent. Inpatient mortality was 12.5% and 37.5% of patients were discharged to a nursing facility. Of all patients in the cohort, 50.0% were discharged home, and 66.7% of patients who were functionally independent at baseline were discharged to home. CONCLUSIONS: New physical debility is a common feature of severe sepsis in patients initially cared for on the general medical floor. Debility occurs even in those with good baseline physical function. Interventions to improve the poor functional outcomes of this population are urgently needed. BioMed Central 2013-12-12 /pmc/articles/PMC3924161/ /pubmed/24330544 http://dx.doi.org/10.1186/1471-2334-13-588 Text en Copyright © 2013 Odden et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Odden, Andrew J Rohde, Jeffrey M Bonham, Catherine Kuhn, Latoya Malani, Preeti N Chen, Lena M Flanders, Scott A Iwashyna, Theodore J Functional outcomes of general medical patients with severe sepsis |
title | Functional outcomes of general medical patients with severe sepsis |
title_full | Functional outcomes of general medical patients with severe sepsis |
title_fullStr | Functional outcomes of general medical patients with severe sepsis |
title_full_unstemmed | Functional outcomes of general medical patients with severe sepsis |
title_short | Functional outcomes of general medical patients with severe sepsis |
title_sort | functional outcomes of general medical patients with severe sepsis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924161/ https://www.ncbi.nlm.nih.gov/pubmed/24330544 http://dx.doi.org/10.1186/1471-2334-13-588 |
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