Faheem W Guirgis1, Lisa Jones2, Rhemar Esma3, Alice Weiss4, Kaitlin McCurdy5, Jason Ferreira6, Christina Cannon7, Laura McLauchlin8, Carmen Smotherman9, Dale F Kraemer10, Cynthia Gerdik11, Kendall Webb12, Jin Ra13, Frederick A Moore14, Kelly Gray-Eurom15. 1. University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL, USA. Electronic address: Faheem.Guirgis@jax.ufl.edu. 2. University of Florida College of Medicine, Jacksonville, Division of Pulmonary Critical Care Medicine, Department of Medicine, Jacksonville, FL, USA. Electronic address: Lisa.Jones@jax.ufl.edu. 3. UF Health Jacksonville, Quality Management, Jacksonville, FL, USA. Electronic address: Rhemar.Esma@jax.ufl.edu. 4. UF Health Jacksonville, Quality Management, Jacksonville, FL, USA. Electronic address: Alice.Weiss@jax.ufl.edu. 5. University of Florida College of Medicine, Jacksonville, Department of Medicine, USA. Electronic address: Kaitlin.Mccurdy@jax.ufl.edu. 6. University of Florida College of Pharmacy, Jacksonville, USA. Electronic address: Jason.Ferreira@jax.ufl.edu. 7. University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL, USA. Electronic address: Christina.Cannon@jax.ufl.edu. 8. University of Florida College of Medicine, Jacksonville, Department of Neurosurgery, USA. Electronic address: Laura.Mclauchlin@jax.ufl.edu. 9. University of Florida College of Medicine, Jacksonville, Center for Health Equity and Quality Research, USA. Electronic address: Carmen.Smotherman@jax.ufl.edu. 10. University of Florida College of Medicine, Jacksonville, Center for Health Equity and Quality Research, USA. Electronic address: Dale.Kraemer@jax.ufl.edu. 11. UF Health Jacksonville, USA. Electronic address: Cynthia.Gerdik@jax.ufl.edu. 12. University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL, USA. Electronic address: Kendall.Webb@jax.ufl.edu. 13. University of Florida College of Medicine, Jacksonville, Department of Surgery, USA. Electronic address: Jin.Ra@jax.ufl.edu. 14. University of Florida College of Medicine, Gainesville, Department of Surgery, USA. Electronic address: Frederick.Moore@surgery.ufl.edu. 15. University of Florida College of Medicine, Jacksonville, Department of Emergency Medicine, Jacksonville, FL, USA. Electronic address: Kelly.Grayeurom@jax.ufl.edu.
Abstract
PURPOSE: Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p=0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39-0.99, p=0.046), mean intensive care unit LOS (2.12days before, 95%CI 1.97, 2.34; 1.95days after, 95%CI 1.75, 2.06; p<0.001), mean overall hospital LOS (11.7days before, 95% CI 10.9, 12.7days; 9.9days after, 95% CI 9.3, 10.6days, p<0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p=0.007), and total charges with a savings of $7159 per sepsis admission (p=0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p=0.18). CONCLUSION: A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.
PURPOSE:Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p=0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39-0.99, p=0.046), mean intensive care unit LOS (2.12days before, 95%CI 1.97, 2.34; 1.95days after, 95%CI 1.75, 2.06; p<0.001), mean overall hospital LOS (11.7days before, 95% CI 10.9, 12.7days; 9.9days after, 95% CI 9.3, 10.6days, p<0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p=0.007), and total charges with a savings of $7159 per sepsis admission (p=0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p=0.18). CONCLUSION: A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.
Authors: Faheem W Guirgis; Cynthia Gerdik; Robert L Wears; Deborah J Williams; Colleen J Kalynych; Joseph Sabato; Steven A Godwin Journal: Resuscitation Date: 2013-08-29 Impact factor: 5.262
Authors: Christopher W Seymour; Vincent X Liu; Theodore J Iwashyna; Frank M Brunkhorst; Thomas D Rea; André Scherag; Gordon Rubenfeld; Jeremy M Kahn; Manu Shankar-Hari; Mervyn Singer; Clifford S Deutschman; Gabriel J Escobar; Derek C Angus Journal: JAMA Date: 2016-02-23 Impact factor: 56.272
Authors: Donald M Yealy; John A Kellum; David T Huang; Amber E Barnato; Lisa A Weissfeld; Francis Pike; Thomas Terndrup; Henry E Wang; Peter C Hou; Frank LoVecchio; Michael R Filbin; Nathan I Shapiro; Derek C Angus Journal: N Engl J Med Date: 2014-03-18 Impact factor: 91.245
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Crit Care Med Date: 2003-04 Impact factor: 7.598
Authors: Faheem W Guirgis; Cynthia Gerdik; Robert L Wears; Colleen J Kalynych; Joseph Sabato; Steven A Godwin Journal: J Patient Saf Date: 2017-03 Impact factor: 2.844
Authors: Andrew Rhodes; Gary Phillips; Richard Beale; Maurizio Cecconi; Jean Daniel Chiche; Daniel De Backer; Jigeeshu Divatia; Bin Du; Laura Evans; Ricard Ferrer; Massimo Girardis; Despoina Koulenti; Flavia Machado; Steven Q Simpson; Cheng Cheng Tan; Xavier Wittebole; Mitchell Levy Journal: Intensive Care Med Date: 2015-06-25 Impact factor: 17.440
Authors: Hannah J Kimmel; Yanick N Brice; Thomas A Trikalinos; Indra Neil Sarkar; Megan L Ranney Journal: Telemed J E Health Date: 2018-08-21 Impact factor: 3.536
Authors: Zhongheng Zhang; Lin Chen; Ping Xu; Qing Wang; Jianjun Zhang; Kun Chen; Casey M Clements; Leo Anthony Celi; Vitaly Herasevich; Yucai Hong Journal: NPJ Digit Med Date: 2022-07-19
Authors: Faheem W Guirgis; Christiaan Leeuwenburgh; Lyle Moldawer; Gabriela Ghita; Lauren Page Black; Morgan Henson; Elizabeth DeVos; David Holden; Phil Efron; Srinivasa T Reddy; Frederick A Moore Journal: Ann Intensive Care Date: 2021-05-20 Impact factor: 6.925
Authors: Faheem W Guirgis; Lauren Page Black; Martin Daniel Rosenthal; Morgan Henson; Jason Ferreira; Christiaan Leeuwenburgh; Colleen Kalynych; Lyle L Moldawer; Taylor Miller; Lisa Jones; Marie Crandall; Srinivasa T Reddy; Samuel S Wu; Frederick A Moore Journal: BMJ Open Date: 2019-09-18 Impact factor: 2.692
Authors: Meera Joshi; Hutan Ashrafian; Sonal Arora; Sadia Khan; Graham Cooke; Ara Darzi Journal: J Med Internet Res Date: 2019-12-20 Impact factor: 5.428
Authors: Kate Honeyford; Graham S Cooke; Anne Kinderlerer; Elizabeth Williamson; Mark Gilchrist; Alison Holmes; Ben Glampson; Abdulrahim Mulla; Ceire Costelloe Journal: J Am Med Inform Assoc Date: 2020-02-01 Impact factor: 4.497