Risk Factors for Mortality, Intensive Care Unit Admission, and Bacteremia in Patients Suspected of Sepsis at the Emergency Department: A Prospective Cohort Study

被引：6

作者：

D'Onofrio, Valentino ^{[1
,2
,3
,4
]}

Meersman, Agnes ^{[5
]}

Vijgen, Sara ^{[6
]}

Cartuyvels, Reinoud ^{[6
]}

Messiaen, Peter ^{[1
,2
]}

Gyssens, Inge C. ^{[1
,3
,4
]}

机构：

[1] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium

[2] Jessa Hosp, Dept Infect Dis & Immun, Hasselt, Belgium

[3] Radboud Univ Nijmegen, Dept Internal Med, Med Ctr, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[4] Radboud Univ Nijmegen, Radboud Ctr Infect Dis, Med Ctr, Nijmegen, Netherlands

[5] Jessa Hosp, Emergency Dept, Hasselt, Belgium

[6] Jessa Hosp, Clin Lab, Hasselt, Belgium

来源：

OPEN FORUM INFECTIOUS DISEASES | 2021年 / 8卷 / 01期

基金：

欧盟地平线“2020”;

关键词：

bacteremia; emergency department; ICU admission; risk factors; sepsis; ORGAN FAILURE; DEFINITIONS; GUIDELINES; MANAGEMENT; SCORES;

D O I：

10.1093/ofid/ofaa594

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. There is a clear need for a better assessment of independent risk factors for in-hospital mortality, intensive care unit admission, and bacteremia in patients presenting with suspected sepsis at the emergency department. Methods. A prospective observational cohort study including 1690 patients was performed. Two multivariable logistic regression models were used to identify independent risk factors. Results. Sequential organ failure assessment (SOFA) score of >= 2 and serum lactate of >= 2mmol/L were associated with all outcomes. Other independent risk factors were individual SOFA variables and systemic inflammatory response syndrome variables but varied per outcome. Mean arterial pressure <70 mmHg negatively impacted all outcomes. Conclusions. These readily available measurements can help with early risk stratification and prediction of prognosis.

引用

页数：6

共 20 条

[1] DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].

BONE, RC ;

BALK, RA ;

CERRA, FB ;

DELLINGER, RP ;

FEIN, AM ;

KNAUS, WA ;

SCHEIN, RMH ;

SIBBALD, WJ .

CHEST, 1992, 101 (06) :1644-1655

[2] Quick Sepsis-related Organ Failure Assessment; Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit [J].

Churpek, Matthew M. ;

Snyder, Ashley ;

Han, Xuan ;

Sokol, Sarah ;

Pettit, Natasha ;

Howell, Michael D. ;

Edelson, Dana P. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195 (07) :906-911

[3] Sepsis is frequent in initially non-critical hypotensive emergency department patients and is associated with increased mortality [J].

Coeckelenbergh, Sean ;

Van Nuffelen, Marc ;

Melot, Christian .

AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2019, 37 (12) :2242-2245

[4] Predicting bacteraemia in validated models-a systematic review [J].

Eliakim-Raz, N. ;

Bates, D. W. ;

Leibovici, L. .

CLINICAL MICROBIOLOGY AND INFECTION, 2015, 21 (04) :295-301

[5] Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department [J].

Freund, Yonathan ;

Lemachatti, Najla ;

Krastinova, Evguenia ;

Van Laer, Marie ;

Claessens, Yann-Erick ;

Avondo, Aurelie ;

Occelli, Celine ;

Feral-Pierssens, Anne-Laure ;

Truchot, Jennifer ;

Ortega, Mar ;

Carneiro, Bruno ;

Pernet, Julie ;

Claret, Pierre-Geraud ;

Dami, Fabrice ;

Bloom, Ben ;

Riou, Bruno ;

Beaune, Sebastien .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2017, 317 (03) :301-308

[6] Prognostic scores for early stratification of septic patients admitted to an emergency department-high dependency unit [J].

Innocenti, Francesca ;

Bianchi, Simone ;

Guerrini, Elisa ;

Vicidomini, Sonia ;

Conti, Alberto ;

Zanobetti, Maurizio ;

Pini, Riccardo .

EUROPEAN JOURNAL OF EMERGENCY MEDICINE, 2014, 21 (04) :254-259

[7] Defining persistent Staphylococcus aureus bacteraemia: secondary analysis of a prospective cohort study [J].

Kuehl, Richard ;

Morata, Laura ;

Boeing, Christian ;

Subirana, Isaac ;

Seifert, Harald ;

Rieg, Siegbert ;

Kern, Winfried V. ;

Kim, Hong Bin ;

Kim, Eu Suk ;

Liao, Chun-Hsing ;

Tilley, Robert ;

Lopez-Cortes, Luis Eduardo ;

Llewelyn, Martin J. ;

Fowler, Vance G. ;

Thwaites, Guy ;

Cisneros, Jose Miguel ;

Scarborough, Matt ;

Nsutebu, Emmanuel ;

Ferrer, Mercedes Gurgui ;

Perez, Jose L. ;

Barlow, Gavin ;

Hopkins, Susan ;

Ternavasio-de la Vega, Hugo Guillermo ;

Toeroek, M. Estee ;

Wilson, Peter ;

Kaasch, Achim J. ;

Soriano, Alex .

LANCET INFECTIOUS DISEASES, 2020, 20 (12) :1409-1417

[8] Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis [J].

Kyriazopoulou, Evdoxia ;

Leventogiannis, Konstantinos ;

Norrby-Teglund, Anna ;

Dimopoulos, Georgios ;

Pantazi, Aikaterini ;

Orfanos, Stylianos E. ;

Rovina, Nikoletta ;

Tsangaris, Iraklis ;

Gkavogianni, Theologia ;

Botsa, Elektra ;

Chassiou, Eleftheria ;

Kotanidou, Anastasia ;

Kontouli, Christina ;

Chaloulis, Panagiotis ;

Velissaris, Dimitrios ;

Savva, Athina ;

Cullberg, Jonas-Sunden ;

Akinosoglou, Karolina ;

Gogos, Charalambos ;

Armaganidis, Apostolos ;

Giamarellos-Bourboulis, Evangelos J. .

BMC MEDICINE, 2017, 15

[9]

Latten G, 2020, BMJ OPEN, V10

[10] Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 [J].

Rhodes, Andrew ;

Evans, Laura E. ;

Alhazzani, Waleed ;

Levy, Mitchell M. ;

Antonelli, Massimo ;

Ferrer, Ricard ;

Kumar, Anand ;

Sevransky, Jonathan E. ;

Sprung, Charles L. ;

Nunnally, Mark E. ;

Rochwerg, Bram ;

Rubenfeld, Gordon D. ;

Angus, Derek C. ;

Annane, Djillali ;

Beale, Richard J. ;

Bellinghan, Geoffrey J. ;

Bernard, Gordon R. ;

Chiche, Jean-Daniel ;

Coopersmith, Craig ;

De Backer, Daniel P. ;

French, Craig J. ;

Fujishima, Seitaro ;

Gerlach, Herwig ;

Hidalgo, Jorge Luis ;

Hollenberg, Steven M. ;

Jones, Alan E. ;

Karnad, Dilip R. ;

Kleinpell, Ruth M. ;

Koh, Younsuk ;

Lisboa, Thiago Costa ;

Machado, Flavia R. ;

Marini, John J. ;

Marshall, John C. ;

Mazuski, John E. ;

McIntyre, Lauralyn A. ;

McLean, Anthony S. ;

Mehta, Sangeeta ;

Moreno, Rui P. ;

Myburgh, John ;

Navalesi, Paolo ;

Nishida, Osamu ;

Osborn, Tiffany M. ;

Perner, Anders ;

Plunkett, Colleen M. ;

Ranieri, Marco ;

Schorr, Christa A. ;

Seckel, Maureen A. ;

Seymour, Christopher W. ;

Shieh, Lisa ;

Shukri, Khalid A. .

INTENSIVE CARE MEDICINE, 2017, 43 (03) :304-377

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