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Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis

BACKGROUND: Sepsis has a high prevalence, mortality-rate and cost. Sepsis patients usually enter the hospital through the Emergency Department (ED). Process or structural issues related to care may affect outcome. METHODS: Multi-centered retrospective observational cohort study using administrative...

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Autores principales: Yergens, Dean W., Ghali, William A., Faris, Peter D., Quan, Hude, Jolley, Rachel J., Doig, Christopher J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610044/
https://www.ncbi.nlm.nih.gov/pubmed/26481448
http://dx.doi.org/10.1186/s12873-015-0049-y
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author Yergens, Dean W.
Ghali, William A.
Faris, Peter D.
Quan, Hude
Jolley, Rachel J.
Doig, Christopher J.
author_facet Yergens, Dean W.
Ghali, William A.
Faris, Peter D.
Quan, Hude
Jolley, Rachel J.
Doig, Christopher J.
author_sort Yergens, Dean W.
collection PubMed
description BACKGROUND: Sepsis has a high prevalence, mortality-rate and cost. Sepsis patients usually enter the hospital through the Emergency Department (ED). Process or structural issues related to care may affect outcome. METHODS: Multi-centered retrospective observational cohort study using administrative databases to identify adult patients (> = 18 years) with sepsis and severe sepsis admitted to Alberta Health Services Calgary zone adult multisystem intensive care units (ICU) through the ED between January 1, 2006 and September 30, 2009. We examined the association between ICU occupancy and hospital outcome. We explored other associations of hospital outcome including the effect of ED wait time, admission from ED during weekdays versus weekends and ED admission during the day versus at night. RESULTS: One thousand and seven hundred seventy patients were admitted to hospital via ED, 1036 (58.5 %) with sepsis and 734 (41.5 %) with severe sepsis. In patients with sepsis, ICU occupancy > 90 % was associated with an increase in hospital mortality even after adjusting for age, sex, triage level, Charlson index, time of first ED physician assessment and ICU admission. No differences in hospital mortality were found for patients who waited more than 7 h, were admitted during the day versus night or weekdays versus weekends. CONCLUSIONS: In patients with sepsis admitted via the ED, increased ICU occupancy was associated with higher in-hospital mortality.
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spelling pubmed-46100442015-10-20 Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis Yergens, Dean W. Ghali, William A. Faris, Peter D. Quan, Hude Jolley, Rachel J. Doig, Christopher J. BMC Emerg Med Research Article BACKGROUND: Sepsis has a high prevalence, mortality-rate and cost. Sepsis patients usually enter the hospital through the Emergency Department (ED). Process or structural issues related to care may affect outcome. METHODS: Multi-centered retrospective observational cohort study using administrative databases to identify adult patients (> = 18 years) with sepsis and severe sepsis admitted to Alberta Health Services Calgary zone adult multisystem intensive care units (ICU) through the ED between January 1, 2006 and September 30, 2009. We examined the association between ICU occupancy and hospital outcome. We explored other associations of hospital outcome including the effect of ED wait time, admission from ED during weekdays versus weekends and ED admission during the day versus at night. RESULTS: One thousand and seven hundred seventy patients were admitted to hospital via ED, 1036 (58.5 %) with sepsis and 734 (41.5 %) with severe sepsis. In patients with sepsis, ICU occupancy > 90 % was associated with an increase in hospital mortality even after adjusting for age, sex, triage level, Charlson index, time of first ED physician assessment and ICU admission. No differences in hospital mortality were found for patients who waited more than 7 h, were admitted during the day versus night or weekdays versus weekends. CONCLUSIONS: In patients with sepsis admitted via the ED, increased ICU occupancy was associated with higher in-hospital mortality. BioMed Central 2015-10-19 /pmc/articles/PMC4610044/ /pubmed/26481448 http://dx.doi.org/10.1186/s12873-015-0049-y Text en © Yergens et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Yergens, Dean W.
Ghali, William A.
Faris, Peter D.
Quan, Hude
Jolley, Rachel J.
Doig, Christopher J.
Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title_full Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title_fullStr Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title_full_unstemmed Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title_short Assessing the association between occupancy and outcome in critically Ill hospitalized patients with sepsis
title_sort assessing the association between occupancy and outcome in critically ill hospitalized patients with sepsis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610044/
https://www.ncbi.nlm.nih.gov/pubmed/26481448
http://dx.doi.org/10.1186/s12873-015-0049-y
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