Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance

Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patien...

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Main Authors: Michael Agustin, Lori Lyn Price, Augustine Andoh-Duku, Peter LaCamera
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/9616545
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author Michael Agustin
Lori Lyn Price
Augustine Andoh-Duku
Peter LaCamera
author_facet Michael Agustin
Lori Lyn Price
Augustine Andoh-Duku
Peter LaCamera
author_sort Michael Agustin
collection DOAJ
description Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. Results. Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions (p=0.68). Both groups have similar compliance with the 3-hour protocol (p=0.77). There was no significant difference in achieving optimal resuscitation within 12 hours (p=0.35). Conclusion. We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.
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spelling doaj-art-fd23b84c3f95426daa2e0c99b14443722025-08-20T02:22:39ZengWileyCritical Care Research and Practice2090-13052090-13132017-01-01201710.1155/2017/96165459616545Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol ComplianceMichael Agustin0Lori Lyn Price1Augustine Andoh-Duku2Peter LaCamera3Department of Pulmonary and Critical Care, St. Elizabeth’s Medical Center, Tufts University, Boston, MA, USAClinical and Translational Science Institute, Tufts University, 35 Kneeland Street, Boston, MA, USADepartment of Pulmonary and Critical Care, St. Elizabeth’s Medical Center, Tufts University, Boston, MA, USADepartment of Pulmonary and Critical Care, St. Elizabeth’s Medical Center, Tufts University, Boston, MA, USARationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. Results. Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions (p=0.68). Both groups have similar compliance with the 3-hour protocol (p=0.77). There was no significant difference in achieving optimal resuscitation within 12 hours (p=0.35). Conclusion. We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.http://dx.doi.org/10.1155/2017/9616545
spellingShingle Michael Agustin
Lori Lyn Price
Augustine Andoh-Duku
Peter LaCamera
Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
Critical Care Research and Practice
title Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
title_full Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
title_fullStr Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
title_full_unstemmed Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
title_short Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance
title_sort impact of delayed admission to the intensive care unit from the emergency department upon sepsis outcomes and sepsis protocol compliance
url http://dx.doi.org/10.1155/2017/9616545
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