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There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study

Admission to the emergency department (ED) on weekends has been associated with an increase in mortality and poor outcomes, but the associated findings are not consistent. It has been hypothesized that this association may be due to lower adherence to standards of care. This study was conducted to e...

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Autores principales: Fahel, Bruno V. B., Manciola, Marina, Lima, Gabriel, Barbosa, Manoel H., Starteri, Chuva, Ramos, João Gabriel Rosa, Caldas, Juliana R., Passos, Rogério da Hora
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676526/
https://www.ncbi.nlm.nih.gov/pubmed/33217847
http://dx.doi.org/10.1097/MD.0000000000023256
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author Fahel, Bruno V. B.
Manciola, Marina
Lima, Gabriel
Barbosa, Manoel H.
Starteri, Chuva
Ramos, João Gabriel Rosa
Caldas, Juliana R.
Passos, Rogério da Hora
author_facet Fahel, Bruno V. B.
Manciola, Marina
Lima, Gabriel
Barbosa, Manoel H.
Starteri, Chuva
Ramos, João Gabriel Rosa
Caldas, Juliana R.
Passos, Rogério da Hora
author_sort Fahel, Bruno V. B.
collection PubMed
description Admission to the emergency department (ED) on weekends has been associated with an increase in mortality and poor outcomes, but the associated findings are not consistent. It has been hypothesized that this association may be due to lower adherence to standards of care. This study was conducted to evaluate whether weekend admissions to the ED increases the time to antibiotic administration in septic patients. A retrospective cohort study of adult patients who were included in the sepsis protocol at a tertiary ED between January 2015 and December 2017 was performed. The sepsis protocol was activated for all patients with suspected severe infection. A total of 831 patients with a mean age of 59 ± 21 years were evaluated, of whom 217 (26.1%) were admitted on weekends. In addition, 391 (47.1%) patients were male, and 84 (10.1%) died in the hospital. Overall, the mean sequential organ failure assessment score was 2 ± 1.9, and the mean Charlson comorbidity index was 3.7 ± 3. The time to antibiotic administration was similar between patients admitted on weekends (36.29 ± 50 minutes CI 95%) and patients admitted on weekdays (44.44 ± 69 minutes CI 95%), P = .06; U = 60174.0. Additionally, mortality was similar in both groups of patients, with a 10.3% mortality rate on weekdays and a 9.8% mortality rate on weekends, P = 821. In this cohort of patients with suspicion of sepsis in the ED, admission on weekends was not associated with increased delays in antibiotic therapy or higher mortality rates.
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spelling pubmed-76765262020-11-24 There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study Fahel, Bruno V. B. Manciola, Marina Lima, Gabriel Barbosa, Manoel H. Starteri, Chuva Ramos, João Gabriel Rosa Caldas, Juliana R. Passos, Rogério da Hora Medicine (Baltimore) 3900 Admission to the emergency department (ED) on weekends has been associated with an increase in mortality and poor outcomes, but the associated findings are not consistent. It has been hypothesized that this association may be due to lower adherence to standards of care. This study was conducted to evaluate whether weekend admissions to the ED increases the time to antibiotic administration in septic patients. A retrospective cohort study of adult patients who were included in the sepsis protocol at a tertiary ED between January 2015 and December 2017 was performed. The sepsis protocol was activated for all patients with suspected severe infection. A total of 831 patients with a mean age of 59 ± 21 years were evaluated, of whom 217 (26.1%) were admitted on weekends. In addition, 391 (47.1%) patients were male, and 84 (10.1%) died in the hospital. Overall, the mean sequential organ failure assessment score was 2 ± 1.9, and the mean Charlson comorbidity index was 3.7 ± 3. The time to antibiotic administration was similar between patients admitted on weekends (36.29 ± 50 minutes CI 95%) and patients admitted on weekdays (44.44 ± 69 minutes CI 95%), P = .06; U = 60174.0. Additionally, mortality was similar in both groups of patients, with a 10.3% mortality rate on weekdays and a 9.8% mortality rate on weekends, P = 821. In this cohort of patients with suspicion of sepsis in the ED, admission on weekends was not associated with increased delays in antibiotic therapy or higher mortality rates. Lippincott Williams & Wilkins 2020-11-20 /pmc/articles/PMC7676526/ /pubmed/33217847 http://dx.doi.org/10.1097/MD.0000000000023256 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 3900
Fahel, Bruno V. B.
Manciola, Marina
Lima, Gabriel
Barbosa, Manoel H.
Starteri, Chuva
Ramos, João Gabriel Rosa
Caldas, Juliana R.
Passos, Rogério da Hora
There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title_full There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title_fullStr There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title_full_unstemmed There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title_short There is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: A retrospective cohort study
title_sort there is no association between weekend admissions and delays in antibiotic administration for patients admitted to the emergency department with suspicion of sepsis: a retrospective cohort study
topic 3900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676526/
https://www.ncbi.nlm.nih.gov/pubmed/33217847
http://dx.doi.org/10.1097/MD.0000000000023256
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