Sepsis is frequent in initially non-critical hypotensive emergency department patients and is associated with increased mortality.
Am J Emerg Med
; 37(12): 2242-2245, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31466913
ABSTRACT
OBJECTIVE:
Hypotension, defined as a mean arterial pressure of maximum 70â¯mmHg, is associated with significant morbidity and mortality. The objective of this study was to determine in initially non-critical hypotensive adult patients the proportion of sepsis and if septic patients had different outcome and clinical factors than non-septic patients.METHODS:
This retrospective observational study was conducted over a year on adult hypotensive emergency department patients initially considered by triage as non-critical. Patients were separated into three groups hypotensive septic patients (HSP), hypotensive non-septic infected patients (HNSIP), and other hypotensive patients (OHP). Clinical scores, signs, length of stay (LOS), and mortality were compared using analysis of variance for continuous variables and chi-square analysis for categorical variables.RESULTS:
There were 136 (35.5%) septic patients, 37 (9.7%) with non-septic infection, and 210 (54.8%) with another cause of hypotension. Overall in-hospital mortality was 12.0% and total mortality was greater in HSP than in HNSIP (20.6% vs. 5.4%, pâ¯=â¯0.031) or OHP (20.6 vs. 7.6%, pâ¯<â¯0.001). LOS was greater for HSP when compared to HNSIP (median(IQR) 9(6-17) vs. 6(1-13), pâ¯=â¯0.004) and OHP (median(IQR) 9(6-17) vs. 3(1-8) days, pâ¯<â¯0.0001).CONCLUSION:
Sepsis in a priori non-critical hypotensive adult patients, when compared with other causes of hypotension, is associated with significantly higher mortality and increased LOS. Patients that present to the emergency department and have a MAP of 70mmHg or less must be rigorously evaluated and have consistent follow-up.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Sepsis
/
Presión Arterial
/
Hipotensión
Tipo de estudio:
Observational_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2019
Tipo del documento:
Article