BACKGROUND: The Surviving Sepsis Campaign (SSC) promotes a bundle approach to the care of septic patients to improve outcome. Some have questioned the capability of delivering the bundle in emergency departments (EDs). The authors report the epidemiology and 6 h bundle compliance of patients with severe sepsis/septic shock presenting to Scottish EDs. METHODS: Analysis of the previously reported Scottish Trauma Audit Group sepsis database was performed including 20 mainland Scottish EDs. A total of 308,910 attendances were screened (between 2 March and 31 May 2009), and 5285 of 27,046 patients were identified after case note review and included on the database. This analysis includes patients who had severe sepsis/septic shock before leaving the ED. Epidemiological, severity of illness criteria, and ED management data were analysed. RESULTS: 626 patients (median age 73; M/F ratio 1:1; 637 presentations) met entrance criteria. The median number of cases per site was 16 (range 3-103). 561 (88.1%) patients arrived by ambulance. The most common source of infection was the respiratory tract (n=411, 64.5%) The most common physiological derangements were heart rate (n=523, 82.1%), respiratory rate (n=452, 71%) and white cell count (n=432, 67.8%). The median hospital stay was 9 days (IQR 4-17 days). 201 (31.6%) patients were admitted to critical care within 2 days, 130 (20.4%) directly from the ED. 180 patients (28.3%) died. There was poor compliance with all aspect of the SSC resuscitation bundle. CONCLUSIONS: Sepsis presentations are of variable frequency but have typical epidemiology and clinical outcomes. SSC bundle resuscitation uptake is poor in Scottish EDs.
BACKGROUND: The Surviving Sepsis Campaign (SSC) promotes a bundle approach to the care of septic patients to improve outcome. Some have questioned the capability of delivering the bundle in emergency departments (EDs). The authors report the epidemiology and 6 h bundle compliance of patients with severe sepsis/septic shock presenting to Scottish EDs. METHODS: Analysis of the previously reported Scottish Trauma Audit Group sepsis database was performed including 20 mainland Scottish EDs. A total of 308,910 attendances were screened (between 2 March and 31 May 2009), and 5285 of 27,046 patients were identified after case note review and included on the database. This analysis includes patients who had severe sepsis/septic shock before leaving the ED. Epidemiological, severity of illness criteria, and ED management data were analysed. RESULTS: 626 patients (median age 73; M/F ratio 1:1; 637 presentations) met entrance criteria. The median number of cases per site was 16 (range 3-103). 561 (88.1%) patients arrived by ambulance. The most common source of infection was the respiratory tract (n=411, 64.5%) The most common physiological derangements were heart rate (n=523, 82.1%), respiratory rate (n=452, 71%) and white cell count (n=432, 67.8%). The median hospital stay was 9 days (IQR 4-17 days). 201 (31.6%) patients were admitted to critical care within 2 days, 130 (20.4%) directly from the ED. 180 patients (28.3%) died. There was poor compliance with all aspect of the SSC resuscitation bundle. CONCLUSIONS:Sepsis presentations are of variable frequency but have typical epidemiology and clinical outcomes. SSC bundle resuscitation uptake is poor in Scottish EDs.
Authors: Manu Shankar-Hari; Gary S Phillips; Mitchell L Levy; Christopher W Seymour; Vincent X Liu; Clifford S Deutschman; Derek C Angus; Gordon D Rubenfeld; Mervyn Singer Journal: JAMA Date: 2016-02-23 Impact factor: 56.272
Authors: F Mearelli; D Orso; N Fiotti; N Altamura; A Breglia; M De Nardo; I Paoli; M Zanetti; C Casarsa; G Biolo Journal: Infection Date: 2014-08-11 Impact factor: 3.553
Authors: Young Rock Jang; Su Joa Ahn; Seung Joon Choi; Joong Sik Eom; Yong Kyun Cho; Young Sup Shim; So Hyun Park; Jeong Ho Kim; Hyung-Sik Kim Journal: Abdom Radiol (NY) Date: 2020-08-28
Authors: Manu Shankar-Hari; Deepankar Datta; Julie Wilson; Valentina Assi; Jacqueline Stephen; Christopher J Weir; Jillian Rennie; Jean Antonelli; Anthony Bateman; Jennifer M Felton; Noel Warner; Kevin Judge; Jim Keenan; Alice Wang; Tony Burpee; Alun K Brown; Sion M Lewis; Tracey Mare; Alistair I Roy; John Wright; Gillian Hulme; Ian Dimmick; Alasdair Gray; Adriano G Rossi; A John Simpson; Andrew Conway Morris; Timothy S Walsh Journal: Intensive Care Med Date: 2018-10-05 Impact factor: 17.440
Authors: Donald M Yealy; David T Huang; Anthony Delaney; Marian Knight; Adrienne G Randolph; Ron Daniels; Tim Nutbeam Journal: BMC Med Date: 2015-04-27 Impact factor: 8.775
Authors: Deepankar Datta; Andrew Conway Morris; Jean Antonelli; Noel Warner; Kenneth Alun Brown; John Wright; A John Simpson; Jillian Rennie; Gillian Hulme; Sion Marc Lewis; Tracey Anne Mare; Sharon Cookson; Christopher John Weir; Ian Dimmick; Jim Keenan; Adriano Giorgio Rossi; Manu Shankar-Hari; Timothy S Walsh Journal: BMJ Open Date: 2016-08-01 Impact factor: 2.692