ArticleSouthern medical journal2014
EMS patients and walk-in patients presenting with severe sepsis: differences in management and outcome.
Article in Southern medical journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Impact of Prehospital Care on Outcomes in Sepsis: A Systematic Review.The western journal of emergency medicine · 2016Pooled it
- Association between variables measured in the ambulance and in-hospital mortality among adult patients with and without infection: a prospective cohort study.BMC emergency medicine · 2022Trial
- Interpretable machine learning for predicting sepsis risk in emergency triage patients.Scientific reports · 2025Article
- Sepsis management in pre-hospital care - the earlier, the better?BMC emergency medicine · 2024Article
- Prehospital administration of broad-spectrum antibiotics for sepsis patients: A systematic review and meta-analysis.Health science reports · 2022Article
- Keywords reflecting sepsis presentation based on mode of emergency department arrival: a retrospective cross-sectional study.International journal of emergency medicine · 2021Article
- Prehospital Antibiotics Improve Morbidity and Mortality of Emergency Medical Service Patients with Sepsis.HCA healthcare journal of medicine · 2020Article
- Derivation and internal validation of the screening to enhance prehospital identification of sepsis (SEPSIS) score in adults on arrival at the emergency department.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Article
- Prehospital Care and Emergency Department Door-to-Antibiotic Time in Sepsis.Annals of the American Thoracic Society · 2018Article
- Dispatch and prehospital transport for acute septic patients: an observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Observational
- Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.Internal and emergency medicine · 2016Article
- Recognizing and managing sepsis: what needs to be done?BMC medicine · 2015Article
- Emergency Medical Services Care and Sepsis Trajectories.Prehospital emergency careArticle
- Effect of Prehospital Transport Factors on Shock Index, Serum Lactate, and Mortality in Children with Septic Shock: A Prospective Observational Study.Journal of emergencies, trauma, and shockArticle
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesSepsis is a significant problem. The differences between patients with sepsis who walk into the emergency department (ED) and those who are transported via emergency medical services (EMS) have not been clarified. The aim of the study was to determine whether there was a difference in outcome between patients arriving by EMS and those presenting directly to the ED.
methodsWe prospectively collected and reviewed a cohort of all cases of severe sepsis and septic shock admitted to the medical intensive care unit from the ED from November 2009 to March 2012. Extracted data were basic demographic information (including mode of ED arrival), clinical data, and treatments. We calculated Systemic Inflammatory Response Syndrome criteria, Acute Physiology and Chronic Health Evaluation II scores, and Sequential Organ Failure Assessment (SOFA) scores. The primary outcome was mortality in severely ill patients with sepsis.
resultsA total of 378 subjects (78%) presented by EMS and 107 subjects were walk-in patients (22%). Patients transported via EMS were older (P < 0.01), had fewer lactates >4 (P < 0.02), a more altered mental status (P < 0.01), and higher respiratory rates (P < 0.05) than did walk-in patients. Patients transported by EMS had worse disease severity when measured by an Acute Physiology and Chronic Health Evaluation II score (P < 0.01) but not by SOFA score. EMS patients had a shorter time to receiving antibiotics (P = 0.02) and central line placement (P < 0.01) than did walk-in patients. In a logistic model, mortality was associated with increasing age (adjusted odds ratio 1.3; 95% confidence interval [CI] 1.2-1.4), higher first-measured ED lactates (1.2; 95% CI 1.1-1.2), and increased initial SOFA score (adjusted odds ratio 1.2; 95% CI 1.1-1.3) but not EMS arrival or prehospital fluids.
conclusionsNeither arrival by EMS nor fluid administration by EMS is associated with decreased mortality in severe sepsis.
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What OpenQuestion holds
Registered trials
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.