UMass Chan Medical School Faculty Publications
Title
ICU Admission Source as a Predictor of Mortality for Patients With Sepsis
UMMS Affiliation
Graduate School of Biomedical Sciences, Clinical and Population Health Research Program; Department of Quantitative Health Sciences; Department of Family Medicine and Community Health; Department of Medicine
Publication Date
2017-04-07
Document Type
Article
Disciplines
Bacterial Infections and Mycoses | Critical Care | Emergency Medicine | Pathological Conditions, Signs and Symptoms
Abstract
PURPOSE: Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR).
METHODS: We conducted a retrospective cohort study of 1762 adults with sepsis using ICU record data obtained from a clinical database of an academic medical center. Survival analysis provided crude and adjusted hazard rate ratio (HRR) estimates comparing hospital mortality among patients from hospital wards, EDs, and ORs, adjusted for age, sex, and severity of illness.
RESULTS: Mortality of patients with sepsis differed based on the pre-ICU admission site. Compared to patients admitted from an ED, patients admitted from hospital wards had higher mortality (HRR: 1.35; 95% confidence interval [CI]: 1.09-1.68) and those admitted from an OR had lower mortality (HRR: 0.37; 95% CI: 0.23-0.58).
CONCLUSION: Patients with sepsis admitted to an ICU from a hospital ward experienced greater mortality than patients with sepsis admitted to an ICU from an ED. These findings indicate that there may be systematic differences in the selection of patient care locations, recognition, and management of patients with sepsis that warrant further investigation.
Keywords
emergency department, intensive care unit, sepsis
DOI of Published Version
10.1177/0885066617701904
Source
J Intensive Care Med. 2017 Jan 1:885066617701904. doi: 10.1177/0885066617701904. [Epub ahead of print] Link to article on publisher's site
Related Resources
Journal/Book/Conference Title
Journal of intensive care medicine
PubMed ID
28385105
Repository Citation
Motzkus CA, Chrysanthopoulou SA, Luckmann R, Rincon TA, Lapane KL, Lilly CM. (2017). ICU Admission Source as a Predictor of Mortality for Patients With Sepsis. UMass Chan Medical School Faculty Publications. https://doi.org/10.1177/0885066617701904. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/1414
Comments
First author Christine A. Motzkus is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.