Evidence map›Paper›PMID 26607816›Full record

ArticleIntensive care medicine2016

Septic shock in chronic dialysis patients: clinical characteristics, antimicrobial therapy and mortality.

Edward Clark, Anand Kumar, Amit Langote, Stephen Lapinsky, Peter Dodek, Andreas Kramer, Gordon Wood, Sean M Bagshaw, Ken Wood, Dave Gurka and 2 more

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Article in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
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

7 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 2 countries.

Edward ClarkDepartment of Medicine, Division of Nephrology, The Ottawa Hospital and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Anand KumarDepartments of Medicine, Medical Microbiology and Pharmacology, Section of Critical Care Medicine and Section of Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.
Amit LangoteDepartment of Medicine, Division of Nephrology, The Ottawa Hospital and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Stephen LapinskySection of Critical Care Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada.
Peter DodekSection of Critical Care Medicine, St. Paul's Hospital and University of British Columbia, Vancouver, BC, Canada.
Andreas KramerSection of Critical Care Medicine, Foothills Hospital and University of Calgary, Calgary, AB, Canada.
Gordon WoodSection of Critical Care Medicine, Royal Jubilee Hospital/Victoria General Hospital and University of British Columbia, Victoria, BC, Canada.
Sean M BagshawDivision of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Ken WoodSection of Critical Care Medicine, Geisinger Medical Center, Danville, PA, USA.
Dave GurkaSection of Critical Care Medicine, Rush Medical College, Chicago, IL, USA.
Manish M SoodDepartment of Medicine, Division of Nephrology, The Ottawa Hospital and Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. msood99@gmail.com.
Cooperative Antimicrobial Therapy of Septic Shock Database Research Group
Ottawa Hospital · CAGeisinger Medical Center · USOttawa Hospital Research InstituteRush University Medical Center · USSt. Paul's Hospital · CAUniversity of Alberta · CAUniversity of Calgary · CAUniversity of Manitoba · CAUniversity of Toronto · CAVictoria General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the clinical characteristics and in-hospital mortality of chronic dialysis-dependent end-stage kidney disease patients with septic shock in comparison to septic shock patients not receiving chronic dialysis.

methodsUsing an international, multicenter database, we conducted a retrospective analysis of data collected from 10,414 patients admitted to the intensive care unit (ICU) with septic shock from 1989 to 2013, of which 800 (7.7 %) were chronic dialysis patients. Data on demographic characteristics, sites of infection, microbial pathogens, antimicrobial usage patterns, and in-hospital mortality were aggregated and compared for chronic dialysis and non-dialysis patients. Multivariate time-varying Cox models with and without propensity score matching were constructed to determine the association between dialysis and in-hospital death.

resultsSeptic shock secondary to central venous catheter infection, peritonitis, ischemic bowel, and cellulitis was more frequent in chronic dialysis patients. The isolation of resistant organisms (10.7 vs. 7.1 %; p = 0.005) and delays in receiving antimicrobials (6.0 vs. 5.0 h) were more common in chronic dialysis patients than in non-dialysis patients. Delayed appropriate antimicrobial therapy was associated with an increased risk of death in chronic dialysis patients (p < 0.0001). In-hospital death occurred in 54.8 and 49.0 % of chronic dialysis and non-dialysis patients, respectively. After propensity score matching, there was no difference in overall survival between chronic dialysis and non-dialysis patients, but survival in chronic dialysis patients decreased over time compared to non-dialysis patients.

conclusionsThe demographic and clinical characteristics of chronic dialysis patients with septic shock differ from those of similar non-dialysis patients. However, there was no significant difference in mortality between the chronic dialysis and non-dialysis patients with septic shock enrolled in this analysis.

Indexed as

AdultAgedAged, 80 and overAnti-Infective AgentsCatheterization, Central VenousCatheter-Related InfectionsChronic DiseaseFemaleHospital MortalityHumansMaleMiddle AgedRenal DialysisRetrospective StudiesShock, SepticAnti-Infective AgentsAntimicrobialsDialysisDialysis modalityEpidemiologyIn-hospital mortalityKidney failureSeptic shock

Identifiers

PMID26607816
OpenAlexW2174366572

What OpenQuestion holds

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Registered trials

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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.