Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study
Journal of the Korean Society of Emergency Medicine
; : 465-473, 2018.
Article
em Ko
| WPRIM
| ID: wpr-717565
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE:
We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center.METHODS:
This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality.RESULTS:
A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4–9 vs. 6; IQR, 4–8; P < 0.001). Mechanical ventilator (29% vs. 21%, P < 0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78–1.28; P=0.999) for the transferred group compared with the non-transferred group.CONCLUSION:
The transferred group showed higher severity and needed more organ support procedures than the nontransferred group. However, inter-hospital transfer did not affect in-hospital mortality.Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Prognóstico
/
Choque
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Choque Séptico
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Ventiladores Mecânicos
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Modelos Logísticos
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Razão de Chances
/
Estudos Prospectivos
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Estudos Retrospectivos
/
Mortalidade
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Mortalidade Hospitalar
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
Ko
Revista:
Journal of the Korean Society of Emergency Medicine
Ano de publicação:
2018
Tipo de documento:
Article