National estimates of severe sepsis in United States emergency departments
Top Cited Papers
- 1 August 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 35 (8), 1928-1936
- https://doi.org/10.1097/01.ccm.0000277043.85378.c1
Abstract
The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED length of stay, and case distribution of patients presenting to the ED with suspected severe sepsis. Analysis of 2001-2004 ED data from the National Hospital Ambulatory Medical Care Survey. National multistage probability sample of United States ED data. Adult (age, >or=18 yrs) patients with suspected severe sepsis, defined as the concurrent presence of an infec-tion (ED International Classification of Diseases, 9th Revision; ICD-9) diagnosis of infection, or a triage temperature or=100.4 degrees F) and organ dysfunction (ED ICD-9) diagnosis of organ dysfunction, intubation, or a triage systolic blood pressure 6 hrs in the ED. Of suspected severe sepsis patients, 20.6% presented to a low-volume ED (<or=20,000 annual visits), 15.6% presented to ED in non-Metropolitan Statistical Areas, and 53.5% presented to EDs without medical school affiliations. More than half arrived by ambulance. Suspected severe sepsis patients account for more than 500,000 ED visits annually, with individual patients spending an average of almost 5 hrs in the ED. These national data offer key systemwide information for designing and implementing strategies for severe sepsis treatment.Keywords
This publication has 29 references indexed in Scilit:
- Lack of Implementation and the Barriers to the Use of Early Goal-directed Therapy in Academic Emergency DepartmentsAcademic Emergency Medicine, 2006
- Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol*Critical Care Medicine, 2006
- Translating Research to Clinical PracticeSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2006
- Early Goal-directed Therapy, Corticosteroid, and Recombinant Human Activated Protein C for the Treatment of Severe Sepsis and Septic Shock in the Emergency DepartmentAcademic Emergency Medicine, 2006
- Evidence-based Therapies for Sepsis Care in the Emergency Department: Striking a Balance between Feasibility and NecessityAcademic Emergency Medicine, 2006
- Emergency Medicine and the Surviving Sepsis Campaign: An International Approach to Managing Severe Sepsis and Septic ShockAnnals of Emergency Medicine, 2005
- Clinical review: Emergency department overcrowding and the potential impact on the critically illCritical Care, 2005
- Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shockCritical Care Medicine, 2004
- Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic ShockThe New England Journal of Medicine, 2001
- Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of careCritical Care Medicine, 2001