Evidence map›Paper›PMID 25128441›Full record

Observational studyJournal of critical care2015

Epidemiology and outcomes in patients with severe sepsis admitted to the hospital wards.

Stacey-Ann Whittaker, Barry D Fuchs, David F Gaieski, Jason D Christie, Munish Goyal, Nuala J Meyer, Craig Kean, Dylan S Small, Scarlett L Bellamy, Mark E Mikkelsen

Abstract readObservational Study
In one paragraph

Observational study in Journal of critical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  13. Clinical predictors of early death from sepsis.Journal of critical care · 2017
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Stacey-Ann WhittakerDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Barry D FuchsPulmonary, Allergy, and Critical Care Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
David F GaieskiDepartment of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Jason D ChristiePulmonary, Allergy, and Critical Care Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania.
Munish GoyalDepartment of Emergency Medicine, Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC.
Nuala J MeyerPulmonary, Allergy, and Critical Care Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Craig KeanUniversity of Pennsylvania Health System, Philadelphia, PA.
Dylan S SmallThe Wharton School, University of Pennsylvania, Philadelphia, PA.
Scarlett L BellamyDepartment of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Mark E MikkelsenDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: mark.mikkelsen@uphs.upenn.edu.

Funding

NHLBI NIH HHS L30 HL115698NIGMS NIH HHS L30 GM086101
6 · The paper itself

Abstract

purposeThe purpose of this study was to detail the trajectory and outcomes of patients with severe sepsis admitted from the emergency department to a non-intensive care unit (ICU) setting and identify risk factors associated with adverse outcomes. MATERIAL AND

methodsThis was a single-center retrospective cohort study conducted at a tertiary, academic hospital in the United States between 2005 and 2009. The primary outcome was a composite outcome of ICU transfer within 48 hours of admission and/or 28-day mortality.

resultsOf 1853 patients admitted with severe sepsis, 841 (45%) were admitted to a non-ICU setting, the rate increased over time (P < .001), and 12.5% of these patients were transferred to the ICU within 48 hours and/or died within 28 days. In multivariable models, age (P < .001), an oncology diagnosis (P < .001), and illness severity as measured by Acute Physiologic and Chronic Health Evaluation II (P = .04) and high (≥4 mmol/L) initial serum lactate levels (P = .005) were associated with the primary outcome.

conclusionsPatients presenting to the emergency department with severe sepsis were frequently admitted to a non-ICU setting, and the rate increased over time. Of 8 patients admitted to the hospital ward, one was transferred to the ICU within 48 hours and/or died within 28 days of admission. Factors present at admission were identified that were associated with adverse outcomes.

Indexed as

HospitalizationHospital MortalityAgedAPACHEEmergency Service, HospitalFemaleHumansIntensive Care UnitsMaleMiddle AgedPatient TransferRetrospective StudiesRisk FactorsSepsisUnited StatesICU transferInfectionMortalityOutcomesSevere sepsis

Identifiers

PMID25128441
PMCPMC12288432

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.