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Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate
DC Field | Value | Language |
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dc.contributor.author | 조재화 | - |
dc.date.accessioned | 2021-09-29T00:23:51Z | - |
dc.date.available | 2021-09-29T00:23:51Z | - |
dc.date.issued | 2020-10 | - |
dc.identifier.issn | 0090-3493 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/183807 | - |
dc.description.abstract | Objectives: To investigate the impact of normothermia on compliance with sepsis bundles and in-hospital mortality in patients with sepsis who present to emergency departments. Design: Retrospective multicenter observational study. Patients: Nineteen university-affiliated hospitals of the Korean Sepsis Alliance participated in this study. Data were collected regarding patients who visited emergency departments for sepsis during the 1-month period. The patients were divided into three groups based on their body temperature at the time of triage in the emergency department (i.e., hypothermia [< 36°C] vs normothermia [36-38°C] vs hyperthermia [> 38°C]). Interventions: None. Measurements and main results: Of 64,021 patients who visited emergency departments, 689 with community-acquired sepsis were analyzed (182 hyperthermic, 420 normothermic, and 87 hypothermic patients). The rate of compliance with the total hour-1 bundle was lowest in the normothermia group (6.0% vs 9.3% in hyperthermia vs 13.8% in hypothermia group; p = 0.032), the rate for lactate measurement was lowest in the normothermia group (62.1% vs 73.1% vs 75.9%; p = 0.005), and the blood culture rate was significantly lower in the normothermia than in the hyperthermia group (p < 0.001). The in-hospital mortality rates in the hyperthermia, normothermia, and hypothermia groups were 8.5%, 20.6%, and 30.8%, respectively (p < 0.001), but there was no significant association between compliance with sepsis bundles and in-hospital mortality. However, in a multivariate analysis, compared with hyperthermia, normothermia was significantly associated with an increased in-hospital mortality (odds ratio, 2.472; 95% CI, 1.005-6.080). This association remained significant even after stratifying patients by median lactate level. Conclusions: Normothermia at emergency department triage was significantly associated with an increased risk of in-hospital mortality and a lower rate of compliance with the sepsis bundle. Despite several limitations, our findings suggest a need for new strategies to improve sepsis outcomes in this group of patients. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Lippincott Williams & Wilkins | - |
dc.relation.isPartOf | CRITICAL CARE MEDICINE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Aged, 80 and over | - |
dc.subject.MESH | Body Temperature* | - |
dc.subject.MESH | Emergency Service, Hospital / statistics & numerical data* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Hospital Mortality / trends* | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Hydrogen-Ion Concentration | - |
dc.subject.MESH | Hyperthermia / epidemiology | - |
dc.subject.MESH | Kidney Function Tests | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Organ Dysfunction Scores | - |
dc.subject.MESH | Patient Care Bundles / statistics & numerical data* | - |
dc.subject.MESH | Republic of Korea / epidemiology | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Sepsis / microbiology | - |
dc.subject.MESH | Sepsis / mortality* | - |
dc.subject.MESH | Shock, Septic / microbiology | - |
dc.subject.MESH | Shock, Septic / mortality | - |
dc.title | Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Sunghoon Park | - |
dc.contributor.googleauthor | Kyeongman Jeon | - |
dc.contributor.googleauthor | Dong Kyu Oh | - |
dc.contributor.googleauthor | Eun Young Choi | - |
dc.contributor.googleauthor | Gil Myeong Seong | - |
dc.contributor.googleauthor | Jeongwon Heo | - |
dc.contributor.googleauthor | Youjin Chang | - |
dc.contributor.googleauthor | Won Gun Kwack | - |
dc.contributor.googleauthor | Byung Ju Kang | - |
dc.contributor.googleauthor | Won-Il Choi | - |
dc.contributor.googleauthor | Kyung Chan Kim | - |
dc.contributor.googleauthor | So Young Park | - |
dc.contributor.googleauthor | Yoon Mi Shin | - |
dc.contributor.googleauthor | Heung Bum Lee | - |
dc.contributor.googleauthor | So Hee Park | - |
dc.contributor.googleauthor | Seok Chan Kim | - |
dc.contributor.googleauthor | Sang Hyun Kwak | - |
dc.contributor.googleauthor | Jae Hwa Cho | - |
dc.contributor.googleauthor | Beongki Kim | - |
dc.contributor.googleauthor | Chae-Man Lim | - |
dc.identifier.doi | 10.1097/CCM.0000000000004493 | - |
dc.contributor.localId | A05674 | - |
dc.relation.journalcode | J00654 | - |
dc.identifier.eissn | 1530-0293 | - |
dc.identifier.pmid | 32931189 | - |
dc.identifier.url | https://journals.lww.com/ccmjournal/Fulltext/2020/10000/Normothermia_in_Patients_With_Sepsis_Who_Present.8.aspx | - |
dc.contributor.alternativeName | Cho, Jaehwa | - |
dc.contributor.affiliatedAuthor | 조재화 | - |
dc.citation.volume | 48 | - |
dc.citation.number | 10 | - |
dc.citation.startPage | 1462 | - |
dc.citation.endPage | 1470 | - |
dc.identifier.bibliographicCitation | CRITICAL CARE MEDICINE, Vol.48(10) : 1462-1470, 2020-10 | - |
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