ArticleBMJ open2018
Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Epidemiology and outcomes of adult (non-maternity) community-onset sepsis in Ireland: a secondary analysis of acute hospital administrative data 2020-2024.Irish journal of medical science · 2026Article
- An explainable machine learning model for early pediatric sepsis prediction using cytokine and routine laboratory data.Pediatric research · 2026Article
- Assessing community-acquired acute infection in an irish emergency department: A retrospective observational study protocol.PloS one · 2026Observational
- Early sepsis recognition: a pilot study using a rapid high-multiplex host-response mRNA diagnostic test.Intensive care medicine experimental · 2025Article
- Be-SNAP: the Belgian Sepsis National Action Plan.Frontiers in public health · 2025Article
- Observational
- Diagnostic Delays in Sepsis: Lessons Learned From a Retrospective Study of Canadian Medico-Legal Claims.Critical care explorations · 2023Article
- Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis.Archives of academic emergency medicine · 2023Article
- Article
- Frequency and Types of Healthcare Encounters in the Week Preceding a Sepsis Hospitalization: A Systematic Review.Critical care explorations · 2022Review
- Vital signs of the systemic inflammatory response syndrome in adult patients with acute infections presenting in out-of-hours primary care: A cross-sectional study.The European journal of general practice · 2021Article
- Use of sepsis-related diagnostic criteria in primary care: a survey among general practitioners.Family practice · 2021Article
- Characteristics and Outcomes of Clinic Visits Immediately Preceding Sepsis Hospitalization.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2021Article
- Laboratory and clinical impacts of an overnight laboratory service.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Vital signs, clinical rules, and gut feeling: an observational study among patients with fever.BJGP open · 2021Article
- Development of a clinical prediction rule for sepsis in primary care: protocol for the TeSD-IT study.Diagnostic and prognostic research · 2020Article
- Contacting out-of-hours primary care or emergency medical services for time-critical conditions - impact on patient outcomes.BMC health services research · 2019Observational
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTimely recognition and treatment of sepsis is essential to reduce mortality and morbidity. Acutely ill patients often consult a general practitioner (GP) as the first healthcare provider. During out-of-hours, GP cooperatives deliver this care in the Netherlands. The aim of this study is to explore the role of these GP cooperatives in the care for patients with sepsis.
designRetrospective study of patient records from both the hospital and the GP cooperative.
settingAn intensive care unit (ICU) of a general hospital in the Netherlands, and the colocated GP cooperative serving 260 000 inhabitants.
participantsWe used data from 263 patients who were admitted to the ICU due to community-acquired sepsis between January 2011 and December 2015.
main outcome measuresContact with the GP cooperative within 72 hours prior to hospital admission, type of contact, delay from the contact until hospital arrival, GP diagnosis, initial vital signs and laboratory values, and hospital mortality.
resultsOf 263 patients admitted to the ICU, 127 (48.3%) had prior GP cooperative contacts. These contacts concerned home visits (59.1%), clinic consultations (18.1%), direct ambulance deployment (12.6%) or telephone advice (10.2%). Patients assessed by a GP were referred in 64% after the first contact. The median delay to hospital arrival was 1.7 hours. The GP had not suspected an infection in 43% of the patients. In this group, the in-hospital mortality rate was significantly higher compared with patients with suspected infections (41.9% vs 17.6%). Mortality difference remained significant after correction for confounders.
conclusionGP cooperatives play an important role in prehospital management of sepsis and recognition of sepsis in this setting proved difficult. Efforts to improve management of sepsis in out-of-hours primary care should not be limited to patients with a suspected infection, but also include severely ill patients without clear signs of infection.
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