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Mortality difference between early-identified sepsis and late-identified sepsis

Clinical and Experimental Emergency Medicine 2020년 7권 3호 p.150 ~ 160
지운, 조시온, 이재백, 진영호, 정태오, 윤재철, 박보영,
소속 상세정보
지운 ( Jee Woon ) - Jeonbuk National University Hospital Department of Emergency Medicine
조시온 ( Jo Si-On ) - Jeonbuk National University Medical School Department of Emergency Medicine
이재백 ( Lee Jae-Baek ) - Jeonbuk National University Medical School Department of Emergency Medicine
진영호 ( Jin Young-Ho ) - Jeonbuk National University Medical School Department of Emergency Medicine
정태오 ( Jeong Tae-Oh ) - Jeonbuk National University Medical School Department of Emergency Medicine
윤재철 ( Yoon Jae-Chol ) - Jeonbuk National University Medical School Department of Emergency Medicine
박보영 ( Park Bo-Young ) - Hanyang University College of Medicine Department of Medicine

Abstract


Objective: The aim of the study was to compare the mortality rates of patients with early-identified (EI) sepsis and late-identified (LI) sepsis.

Methods: We performed a retrospective chart review of patients admitted to the emergency department and diagnosed with sepsis. EI sepsis was defined as patients with a Sequential Organ Failure Assessment (SOFA) score ≥2, based on 3 parameters of the SOFA score (Glasgow coma scale, mean arterial pressure, and partial pressure of oxygen/fraction of inspired oxygen ratio), measured within an hour of emergency department admission. The remaining patients were defined as LI sepsis. The primary outcome was in-hospital mortality.

Results: Of the total 204 patients with sepsis, 113 (55.4%) had EI sepsis. Overall mortality rate was 15.7%, and EI sepsis group had significantly higher mortality than LI sepsis (23.0% vs. 6.6%, P=0.003). The patients with EI sepsis, compared to those with LI sepsis, had higher SOFA score (median: 4 vs. 2, P<0.001); Acute Physiology and Chronic Health Evaluation (APACHE) II score (median: 14 vs. 10, P<0.001); were more likely to progress to septic shock within 6 hours after admission (17.7% vs. 1.1%, P<0.001); were more likely to be admitted to the intensive care unit (2.2% vs. 1.1%, P=0.001).

Conclusion: Mortality was significantly higher in the EI sepsis group than in the LI sepsis group.

키워드

Sepsis; Mortality; Shock, septic

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