ArticleJournal of intensive care2023
Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study.
Article in Journal of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Earlier ICU Transfer after CONCERN Early Warning System Score Escalation Reduced Sepsis-related Mortality: Results from a Multi-site Pragmatic Cluster Randomized Controlled Trial.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Trial
- Impact of Intensive Care Unit Type and Organizational Factors on Mortality in Patients Transferred from Internal Medicine Services to the Intensive Care Unit: A Prospective Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Rapid response teams for new leaders: a narrative review of global evidence and implementation strategies with a focus on Japan.BMJ open quality · 2026Review
- Article
- Impact of Endotracheal Intubation Timing on Clinical Outcomes in Patients with Severe Pneumonia: A Single-Center Retrospective Cohort Study.Infection and drug resistance · 2026Article
- Thirty-Day Mortality Associated With Carbapenemase-ProducingOpen forum infectious diseases · 2025Article
- Risk factors for in-hospital mortality in surgical patients with abdominal sepsis in China: a nested case-control study.BMJ open · 2025Article
- Improving acute care outcome in internal medicine: the role of early stabilization and intermediate care unit.Internal and emergency medicine · 2025Observational
- Predicting responsiveness to fixed-dose methylene blue in adult patients with septic shock using interpretable machine learning: a retrospective study.Scientific reports · 2025Article
- Impact of the timing of invasive mechanical ventilation in patients with sepsis: a multicenter cohort study.Critical care (London, England) · 2024Article
- Point-of-Care Serum Proenkephalin as an Early Predictor of Mortality in Patients Presenting to the Emergency Department with Septic Shock.Biomedicines · 2024Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundBased on sparse evidence, the current Surviving Sepsis Campaign guideline suggests that critically ill patients with sepsis be admitted to the intensive care unit (ICU) within 6 h. However, limited ICU bed availability often makes immediate transfer difficult, and it is unclear whether all patients will benefit from early admission to the ICU. Therefore, the purpose of this study was to determine the association between the timing of ICU admission and mortality in patients with hospital-onset sepsis.
methodsThis nationwide prospective cohort study analyzed patients with hospital-onset sepsis admitted to the ICUs of 19 tertiary hospitals between September 2019 and December 2020. ICU admission was classified as either early (within 6 h) or delayed (beyond 6 h). The primary outcome of in-hospital mortality was compared using logistic regression adjusted for key prognostic factors in the unmatched and 1:1 propensity-score-matched cohorts. Subgroup and interaction analyses assessed whether in-hospital mortality varied according to baseline characteristics.
resultsA total of 470 and 286 patients were included in the early and delayed admission groups, respectively. Early admission to the ICU did not significantly result in lower in-hospital mortality in both the unmatched (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 0.99-1.85) and matched cohorts (aOR, 1.38; 95% CI, 0.94-2.02). Subgroup analyses showed that patients with increasing lactate levels (aOR, 2.10; 95% CI, 1.37-3.23; P for interaction = 0.003), septic shock (aOR, 2.06; 95% CI, 1.31-3.22; P for interaction = 0.019), and those who needed mechanical ventilation (aOR, 1.92; 95% CI, 1.24-2.96; P for interaction = 0.027) or vasopressor support (aOR, 1.69; 95% CI, 1.17-2.44; P for interaction = 0.042) on the day of ICU admission had a higher risk of mortality with delayed admission.
conclusionsAmong patients with hospital-onset sepsis, in-hospital mortality did not differ significantly between those with early and delayed ICU admission. However, as early intensive care may benefit those with increasing lactate levels, septic shock, and those who require vasopressors or ventilatory support, admission to the ICU within 6 h should be considered for these subsets of patients.
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