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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
被引:2
作者:
Fahel, Bruno V. B.
[2
]
Manciola, Marina
[2
]
Lima, Gabriel
[3
]
Barbosa, Manoel H.
[3
]
Starteri, Chuva
[3
]
Rosa Ramos, Joao Gabriel
[1
]
Caldas, Juliana R.
[1
,2
,4
]
Passos, Rogerio Hora
[1
]
机构:
[1] Hosp Sao Rafael Rede DOR Sao Luiz HSR, Crit Care Dept, Salvador, BA, Brazil
[2] Escola Bahiana Med & Saude Publ EBMSP, Salvador, BA, Brazil
[3] Fac Med Bahia UFBA, Salvador, BA, Brazil
[4] Univ Salvador UNIFACS, Salvador, BA, Brazil
来源:
关键词:
prognostic;
sepsis;
weekend effect;
INTENSIVE-CARE-UNIT;
HOSPITAL MORTALITY;
WEEKDAY ADMISSION;
SEPTIC SHOCK;
OUTCOMES;
ICU;
D O I:
10.1097/MD.0000000000023256
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
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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