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Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for s...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Emergency Medicine
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052817/ https://www.ncbi.nlm.nih.gov/pubmed/27752550 http://dx.doi.org/10.15441/ceem.14.012 |
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author | Joo, Young Min Chae, Minjung Kathy Hwang, Sung Yeon Jin, Sang-Chan Lee, Tae Rim Cha, Won Chul Jo, Ik Joon Sim, Min Seob Song, Keun Jeong Jeong, Yeon Kwon Shin, Tae Gun |
author_facet | Joo, Young Min Chae, Minjung Kathy Hwang, Sung Yeon Jin, Sang-Chan Lee, Tae Rim Cha, Won Chul Jo, Ik Joon Sim, Min Seob Song, Keun Jeong Jeong, Yeon Kwon Shin, Tae Gun |
author_sort | Joo, Young Min |
collection | PubMed |
description | OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS). RESULTS: A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS. CONCLUSION: Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock. |
format | Online Article Text |
id | pubmed-5052817 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Korean Society of Emergency Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-50528172016-10-17 Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department Joo, Young Min Chae, Minjung Kathy Hwang, Sung Yeon Jin, Sang-Chan Lee, Tae Rim Cha, Won Chul Jo, Ik Joon Sim, Min Seob Song, Keun Jeong Jeong, Yeon Kwon Shin, Tae Gun Clin Exp Emerg Med Original Article OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS). RESULTS: A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS. CONCLUSION: Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock. The Korean Society of Emergency Medicine 2014-09-30 /pmc/articles/PMC5052817/ /pubmed/27752550 http://dx.doi.org/10.15441/ceem.14.012 Text en Copyright © 2014 The Korean Society of Emergency Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/). |
spellingShingle | Original Article Joo, Young Min Chae, Minjung Kathy Hwang, Sung Yeon Jin, Sang-Chan Lee, Tae Rim Cha, Won Chul Jo, Ik Joon Sim, Min Seob Song, Keun Jeong Jeong, Yeon Kwon Shin, Tae Gun Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title | Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title_full | Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title_fullStr | Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title_full_unstemmed | Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title_short | Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
title_sort | impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052817/ https://www.ncbi.nlm.nih.gov/pubmed/27752550 http://dx.doi.org/10.15441/ceem.14.012 |
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